Provider Demographics
NPI:1033938238
Name:MARKIN, MOLLY SHAE
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:SHAE
Last Name:MARKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 71ST ST STE 109
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4828
Mailing Address - Country:US
Mailing Address - Phone:212-606-1011
Mailing Address - Fax:212-472-8024
Practice Address - Street 1:525 E 71ST ST STE 109
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4828
Practice Address - Country:US
Practice Address - Phone:212-606-1011
Practice Address - Fax:212-472-8024
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant