Provider Demographics
NPI:1063414282
Name:MARKOWITZ, RICHARD LOUIS (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LOUIS
Last Name:MARKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1553 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557
Mailing Address - Country:US
Mailing Address - Phone:516-374-1677
Mailing Address - Fax:516-374-8666
Practice Address - Street 1:1553 BROADWAY
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557
Practice Address - Country:US
Practice Address - Phone:516-374-1677
Practice Address - Fax:516-374-8666
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200488207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2599577OtherGHI
NYP669414OtherOXFORD
NY961772OtherAETNA
NY773161OtherBLUE CROSS BLUE SHIELD
NY01888673Medicaid
NYP669414OtherOXFORD
NY961772OtherAETNA