Provider Demographics
NPI:1093849358
Name:ISELIN, MARIE-GENEVIEVE (PHD)
Entity Type:Individual
Prefix:
First Name:MARIE-GENEVIEVE
Middle Name:
Last Name:ISELIN
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 1:7-13 WASHINGTON SQ N
Mailing Address - Street 2:APT. 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6623
Mailing Address - Country:US
Mailing Address - Phone:212-998-2898
Mailing Address - Fax:212-228-2898
Practice Address - Street 1:26 W 9TH ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8971
Practice Address - Country:US
Practice Address - Phone:212-228-2898
Practice Address - Fax:212-228-2898
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16589103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging