Provider Demographics
NPI:1114057577
Name:MARKOWITZ, ADELINE
Entity type:Individual
Prefix:
First Name:ADELINE
Middle Name:
Last Name:MARKOWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1837
Mailing Address - Country:US
Mailing Address - Phone:516-487-4699
Mailing Address - Fax:
Practice Address - Street 1:14 GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1837
Practice Address - Country:US
Practice Address - Phone:516-487-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1857692085N0904X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology