Provider Demographics
NPI:1124152608
Name:MARQUIS, REBEKAH (DO)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:MARQUIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:
Other - Last Name:MARQUIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:232 OGDEN AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-1241
Mailing Address - Country:US
Mailing Address - Phone:201-792-4865
Mailing Address - Fax:
Practice Address - Street 1:288 BOULEVARD
Practice Address - Street 2:
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-1318
Practice Address - Country:US
Practice Address - Phone:201-288-6781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07846000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine