M. Jennifer Demarco D.O., LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

219063 Issued in NY

Legal business name

M. JENNIFER DEMARCO D.O., LLC

Practice address

191 Grand Central Ave
Amityville, NY 11701-3706

Phone

(631) 598-2318

NPI assigned

Oct 26, 2006

Last updated

Oct 1, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Jennifer Demarco, D.O.

Title

Doctor

Phone

(631) 598-2318

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• M. Jennifer Demarco, D.O.

  • Family Medicine Physician
  • Amityville, NY
  • NPI 1265611131
  Medicare reassignment NPD

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1588749535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 GRAND CENTRAL AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 GRAND CENTRAL AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117013706",
            "telephone_number": "631-598-2318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. JENNIFER DEMARCO D.O., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JENNIFER",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "631-598-2318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "219063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Luhr, PHD
• Tanzelya Lyamzina, LPN
• Daniel Lynch
• Diane Lynch, RN
• Sheila Lynch, RN
• Michelle Ma, DDS
• Alexis Mack, LPN
• Joanne Macken, CASAC
• Lauren Nicole Macy, LMCW
• Michelle Madison, LCSW

• Family Medicine Physician in Amityville, NY
• Providers in Amityville, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.