Provider Demographics
NPI:1730327727
Name:MARKSON, SAMIA (PHD)
Entity type:Individual
Prefix:DR
First Name:SAMIA
Middle Name:
Last Name:MARKSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-0355
Mailing Address - Country:US
Mailing Address - Phone:585-755-6597
Mailing Address - Fax:
Practice Address - Street 1:3300 MONROE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-4624
Practice Address - Country:US
Practice Address - Phone:585-755-6597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015810-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist