Provider Demographics
NPI:1376691493
Name:MARGENAU-SPATZ, MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:
Last Name:MARGENAU-SPATZ
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 1:29 HUGHES TER
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1744
Mailing Address - Country:US
Mailing Address - Phone:914-963-1636
Mailing Address - Fax:914-963-3336
Practice Address - Street 1:65 W 55TH ST
Practice Address - Street 2:SUITE 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4913
Practice Address - Country:US
Practice Address - Phone:212-757-5755
Practice Address - Fax:212-956-5655
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007805103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY007805OtherNYS PSYCHOLOGIST LICENSE