Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 006694 | NY |
N | 103T00000X | Psychologist | 006694 | NY |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 006694 | NY |
N | 103TA0700X | Adult Development & Aging Psychologist | 006694 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 006694 | NY |
N | 103G00000X | Clinical Psychologist | 006694 | NY |
N | 103TC0700X | Clinical Psychologist | 006694 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 006694 | NY |
N | 103TF0000X | Family Psychologist | 006694 | NY |
N | 103TP0814X | Psychoanalysis | 006694 | NY |
NPI | 1346454279 |
---|---|
Provider Name | Dr. Karen Marisak |
First Address | New York, NY 10024-3604 |
Second Address | New York, NY 10024-3604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01459828 | (05) | NY |
P590762 | OXFORD PROVIDER ID (01) | NY |