Provider Demographics
NPI:1063588465
Name:MARKS, ROSEMARIE FUSCO (MD)
Entity type:Individual
Prefix:DR
First Name:ROSEMARIE
Middle Name:FUSCO
Last Name:MARKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6545
Mailing Address - Country:US
Mailing Address - Phone:212-772-2121
Mailing Address - Fax:
Practice Address - Street 1:625 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6545
Practice Address - Country:US
Practice Address - Phone:212-772-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153038207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC10095Medicare UPIN
NY45D931Medicare ID - Type Unspecified