Provider Demographics
NPI:1326105172
Name:REMALY, MARJORIE JILL (LCSW)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:JILL
Last Name:REMALY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:
Other - Last Name:REMALY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-0063
Mailing Address - Country:US
Mailing Address - Phone:845-353-4249
Mailing Address - Fax:
Practice Address - Street 1:2050 SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4143
Practice Address - Country:US
Practice Address - Phone:845-353-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR028880-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
7403106OtherGHI
NYNOC141Medicare ID - Type Unspecified