Provider Demographics
NPI:1578448932
Name:MARCUS, REBECCA IRENE (RN)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:IRENE
Last Name:MARCUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 HOLIDAY PARK DR
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2108
Mailing Address - Country:US
Mailing Address - Phone:631-484-2850
Mailing Address - Fax:
Practice Address - Street 1:70 HOLIDAY PARK DR
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2108
Practice Address - Country:US
Practice Address - Phone:631-484-2850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY301584146N00000X
NY995514163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic