Basic Information
| Provider Information | |||||||||
| NPI: | 1598043432 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARMUR DERMATOLOGY AND CARDIOLOGY, PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MARMUR MEDICAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 E 87TH ST SUITE 1A | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 101280501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129966900 | ||||||||
| FaxNumber: | 6463765140 | ||||||||
| Practice Location | |||||||||
| Address1: | 12 E 87TH ST SUITE 1A | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 101280501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129966900 | ||||||||
| FaxNumber: | 6463765140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2011 | ||||||||
| LastUpdateDate: | 04/03/2017 | ||||||||
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| AuthorizedOfficialLastName: | MARMUR | ||||||||
| AuthorizedOfficialFirstName: | ELLEN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2129966900 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ND0101X | 219305 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery |
No ID Information.