Provider Demographics
NPI:1336222165
Name:MARCU, MARIANA
Entity type:Individual
Prefix:
First Name:MARIANA
Middle Name:
Last Name:MARCU
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 1:30 EAST 40TH STREET SUITE 802
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-481-1744
Mailing Address - Fax:212-481-0244
Practice Address - Street 1:30E 40TH ST 802
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1201
Practice Address - Country:US
Practice Address - Phone:212-481-1744
Practice Address - Fax:212-685-0625
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224018207R00000X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02270780Medicaid
NY5N6031Medicare ID - Type Unspecified
H56274Medicare UPIN