Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | P11806 | NY |
Y | 103TC0700X | Clinical Psychologist | P11806 | NY |
NPI | 1003355876 |
---|---|
Provider Name | Dr. Melissa Marcus |
First Address | New York, NY 10010-2736 |
Second Address | New York, NY 10010-2736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2017 |
Last Update Date | 17/09/2018 |