Individual provider Active NPI

Robert W Marder, D.M.D.

  • General Practice Dentistry
  • New City, NY
National Provider Identifier
1124209382
Registry record updated Nov 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
046562 Issued in NY
Practice address
100 Maple Ave
New City, NY 10956-5019
Phone
(845) 634-3868
Fax
(845) 638-2112
NPI assigned
Nov 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 046562 NY Primary

Addresses

Primary practice location

100 Maple Ave
New City, NY 10956-5019

Mailing address

100 Maple Ave
New City, NY 10956-5019
Phone (845) 634-3868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
046562NYMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1124209382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAPLE AVE",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565019",
            "telephone_number": "845-634-3868",
            "fax_number": "845-638-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAPLE AVE",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109565019",
            "telephone_number": "845-634-3868",
            "fax_number": "845-638-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDER",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.