Provider Demographics
NPI:1487765475
Name:MARKS, ELAINE M (PA)
Entity type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:M
Last Name:MARKS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1367 WASHINGTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1069
Mailing Address - Country:US
Mailing Address - Phone:518-489-2666
Mailing Address - Fax:518-489-5933
Practice Address - Street 1:1367 WASHINGTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1069
Practice Address - Country:US
Practice Address - Phone:518-489-2666
Practice Address - Fax:518-489-5933
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0003809-1363AS0400X
NY003809-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical