Provider Demographics
NPI:1306183454
Name:MARAKOWITZ, ELLEN L (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:L
Last Name:MARAKOWITZ
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 1:740 W END AVE
Mailing Address - Street 2:#101
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6246
Mailing Address - Country:US
Mailing Address - Phone:646-734-8392
Mailing Address - Fax:
Practice Address - Street 1:740 W END AVE
Practice Address - Street 2:#101
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6246
Practice Address - Country:US
Practice Address - Phone:646-734-8392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000860102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst