Basic Information
| Provider Information | |||||||||
| NPI: | 1699034025 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARKS | ||||||||
| FirstName: | YAEL | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ROSS | ||||||||
| OtherFirstName: | YAEL | ||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 100 E 77TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100751850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124342000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 480 BEDFORD RD | ||||||||
| Address2: | |||||||||
| City: | CHAPPAQUA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105141715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142231756 | ||||||||
| FaxNumber: | 9142231718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2012 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2086S0102X | 291678 | NY | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No ID Information.