Provider Demographics
NPI:1487966388
Name:MARIAN MARKOWITZ DURABLE MEDICAL EQUIPMENT PROVIDER
Entity type:Organization
Organization Name:MARIAN MARKOWITZ DURABLE MEDICAL EQUIPMENT PROVIDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:401-455-3554
Mailing Address - Street 1:21 GREATON DR
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2913
Mailing Address - Country:US
Mailing Address - Phone:401-455-3554
Mailing Address - Fax:401-455-0043
Practice Address - Street 1:260 OCEAN GROVE AVENUE
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777
Practice Address - Country:US
Practice Address - Phone:401-465-8260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPD1931332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6403550001Medicare NSC