Provider Demographics
NPI:1699879767
Name:MARKOVITS, CLARA (MD)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:MARKOVITS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 YAPHANK RD STE 5A
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4862
Mailing Address - Country:US
Mailing Address - Phone:631-475-5108
Mailing Address - Fax:631-475-2496
Practice Address - Street 1:250 YAPHANK RD SUITE 5A
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-475-5108
Practice Address - Fax:631-475-2496
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY164152207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1786043Medicaid
NY1786043Medicaid
16F181Medicare PIN