Michael Marcus, PHD
Psychologist, Clinical in Lawrence, NY. Individual provider (NPI-1).
NPI number1861035644
StatusActive
Last updated in NPPESJan 24, 2022
Details
- NPI
- 1861035644
- Entity type
- Individual (NPI-1)
- Name
- Michael Marcus
- Credential
- PHD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 23, 2019
- Certification date
- Jan 24, 2022
- Last updated
- Jan 24, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 024615 | NY | Yes |
Practice location
360 Central Ave Ste 110Lawrence, NY 11559-1604
Phone 646-784-2022
Mailing address
360 Central Ave Ste 110Lawrence, NY 11559-1604
Phone 646-784-2022
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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