| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ELIZABETH MARKS | 1396761169 | 2024-11-08 |
Elizabeth A Marks PA [F] graduated in 2005 and primarily specializes in Physician Assistant.
Elizabeth Marks is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1396761169. Registration indicates Elizabeth Marks is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| PECOS ID | 9931132529 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ms. Elizabeth Marks PA-C |
| Practice Office Address | 840 HARRISON AVE BOSTON, MA US |
| Practice Office Telephone | 6176388609 |
| Mailing Address | 960 MASSACHUSETTS AVENUE FL 2 BOSTON, MA 021182690 US |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | AP1968
MA |
| 110124023A | MEDICAID | MA |