Active NPI
Fred William Marcus, D.O.
- Addiction Medicine (Family Medicine) Physician
- Syosset, NY
National Provider Identifier
1710123963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- License
- 132700
- Practice address
- 770 Jericho Tpke
Syosset, NY 11791-4516 - Phone
- (516) 496-2049
- Fax
- (516) 496-2049
- NPI assigned
- Dec 17, 2008
- Last updated
- Dec 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | 132700 | NY | Primary |
Addresses
Primary practice location
770 Jericho Tpke
Syosset, NY 11791-4516
Mailing address
770 Jericho Tpke
Syosset, NY 11791-4516
Phone (516) 496-2049
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 132700 | NY | MD | Addiction Medicine (Family Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229472000000",
"number": "1710123963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "770 JERICHO TPKE",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914516",
"telephone_number": "516-496-2049",
"fax_number": "516-496-2049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 JERICHO TPKE",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914516",
"telephone_number": "516-496-2049",
"fax_number": "516-496-2049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCUS",
"first_name": "FRED",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-17",
"last_updated": "2008-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "",
"desc": "Family Medicine, Addiction Medicine",
"state": "NY",
"license": "132700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syosset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.