Provider Demographics
NPI:1447309430
Name:MARKO, MARLENE (MD)
Entity type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:MARKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 E 88TH ST
Mailing Address - Street 2:#1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0557
Mailing Address - Country:US
Mailing Address - Phone:212-722-0799
Mailing Address - Fax:212-987-6751
Practice Address - Street 1:19 E 88TH ST
Practice Address - Street 2:#1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0557
Practice Address - Country:US
Practice Address - Phone:212-722-0799
Practice Address - Fax:212-987-6751
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1172172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY117217OtherNYS LICENSE