Provider Demographics
NPI:1073680153
Name:ESTAR, ROBERTA MARIEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:MARIEL
Last Name:ESTAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3063
Mailing Address - Country:US
Mailing Address - Phone:212-213-2635
Mailing Address - Fax:212-213-2635
Practice Address - Street 1:117 E 37TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3063
Practice Address - Country:US
Practice Address - Phone:212-213-2635
Practice Address - Fax:212-213-2635
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003034101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health