Individual
MARCIA DEITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2601 OCEAN PKWY, BROOKLYN, NY 11235-7745
(718) 616-4408
(718) 616-4105
Mailing address
1486 OCEAN PKWY, BROOKLYN, NY 11230-6453
(718) 627-3024
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
149383
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00865370
—
NY
Enumeration date
08/25/2006
Last updated
07/08/2007
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