Individual
MRS. BASYA MARCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
62 INDUSTRIAL PARK RD, LAKE ARIEL, PA 18436-5606
(570) 689-7565
Mailing address
1837 FAIR AVE, HONESDALE, PA 18431-2121
(570) 253-5838
(570) 253-1245
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD442139
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025719970002
—
PA
05
—
1025719970003
—
PA
05
—
1025719970004
—
PA
05
—
1025719970005
—
PA
Enumeration date
10/26/2006
Last updated
07/23/2019
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