Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 008795 | NY |
N | 103T00000X | Psychologist | 008795 | NY |
N | 103TA0700X | Adult Development & Aging Psychologist | 008795 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 008795 | NY |
Y | 103G00000X | Clinical Psychologist | 008795 | NY |
Y | 103TC0700X | Clinical Psychologist | 008795 | NY |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 008795 | NY |
N | 103TP0814X | Psychoanalysis | 008795 | NY |
NPI | 1861485583 |
---|---|
Provider Name | Dr. Mary Anne Hanley Geskie |
First Address | Bayport, NY 11705-2205 |
Second Address | West Islip, NY 11795-4418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2005 |
Last Update Date | 13/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0048459 | VALUE OPTIONS ID NUMBER (01) | NY |
02145393 | (05) | NY |