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Organization
MARCUS AVENUE MEDICAL PC
Active
Organization
MARCUS AVENUE MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6058
Entity
Organization
Contact information
Practice address
232 E 30TH ST, NEW YORK, NY 10016-8202
(212) 447-1609
(212) 679-4275
Mailing address
232 E 30TH ST, NEW YORK, NY 10016-8202
(212) 447-1609
(212) 679-4275
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207N00000X
Dermatology Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207RT0003X
Transplant Hepatology Physician
—
—
207VG0400X
Gynecology Physician
—
—
213E00000X
Podiatrist
—
—
Other
Enumeration date
09/27/2019
Last updated
07/08/2022
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