Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MA31300 | NJ |
NPI | 1033174677 |
---|---|
Provider Name | Dr. Ralph E Marcus |
First Address | Teaneck, NJ 07666-3521 |
Second Address | Teaneck, NJ 07666-3521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 23/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B80006 | (02) | NJ |