Provider Demographics
NPI:1467510628
Name:SHENDELL, MARILYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:
Last Name:SHENDELL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-1439
Mailing Address - Country:US
Mailing Address - Phone:914-273-5582
Mailing Address - Fax:
Practice Address - Street 1:20 OLD MAMARONECK RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2060
Practice Address - Country:US
Practice Address - Phone:914-328-0636
Practice Address - Fax:914-273-5687
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010316103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV68451Medicare ID - Type Unspecified