Provider Demographics
NPI:1104896067
Name:NAVEH, MARCIA S (MD)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:S
Last Name:NAVEH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:50 CHARLES LINDBERGH BLVD., SUITE 206
Mailing Address - Street 2:MATRIX MEDICAL NETWORK
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553
Mailing Address - Country:US
Mailing Address - Phone:917-370-7486
Mailing Address - Fax:212-496-1706
Practice Address - Street 1:50 CHARLES LINDBERGH BLVD., SUITE 206
Practice Address - Street 2:MATRIX MEDICAL NETWORK
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553
Practice Address - Country:US
Practice Address - Phone:917-370-7486
Practice Address - Fax:212-496-1706
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2012-01-09
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Provider Licenses
StateLicense IDTaxonomies
NY136589207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00471678Medicaid
NY42A95Medicare ID - Type Unspecified
NY00471678Medicaid