1972582583 NPI number — DR. DAVID LLOYD MARCUS PH.D. LCSW

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972582583 NPI number — DR. DAVID LLOYD MARCUS PH.D. LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARCUS
Provider First Name:
DAVID
Provider Middle Name:
LLOYD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D. LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARCUS
Provider Other First Name:
DAVID
Provider Other Middle Name:
LLOYD
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D. LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1972582583
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
425 MAIN ST
Provider Second Line Business Mailing Address:
APT 3C
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10044-0238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-777-8222
Provider Business Mailing Address Fax Number:
212-263-6271

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
425 MAIN ST
Provider Second Line Business Practice Location Address:
APT 3C
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10044-0238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-777-8222
Provider Business Practice Location Address Fax Number:
212-263-6271
Provider Enumeration Date:
01/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  071570 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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