Provider Demographics
NPI:1316953300
Name:MARKOWITZ, DAVID P
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:MARKOWITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W 34TH ST
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3006
Mailing Address - Country:US
Mailing Address - Phone:917-915-5340
Mailing Address - Fax:212-239-0948
Practice Address - Street 1:875 6TH AVE
Practice Address - Street 2:RM 1705
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3576
Practice Address - Country:US
Practice Address - Phone:917-915-5340
Practice Address - Fax:212-239-0948
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015420103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02607147Medicaid
NY02607147Medicaid
NYQ34614Medicare PIN
NY0404ABMedicare PIN
NY09577Medicare PIN