Provider Demographics
NPI:1427114859
Name:MARKU-PODVORICA, JEHONA (RPA-C)
Entity type:Individual
Prefix:
First Name:JEHONA
Middle Name:
Last Name:MARKU-PODVORICA
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 68TH STREET, BOX 98
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:212-746-3147
Mailing Address - Fax:212-746-8541
Practice Address - Street 1:525 E 68TH STREET, BOX 98
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-746-3147
Practice Address - Fax:212-746-8541
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011655363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant