Provider Demographics
NPI:1467545731
Name:PAREDES, MARGARITA ROSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARGARITA
Middle Name:ROSA
Last Name:PAREDES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MARGARITA
Other - Middle Name:ROSA
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4330 46TH ST 5A
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2049
Mailing Address - Country:US
Mailing Address - Phone:312-852-7783
Mailing Address - Fax:
Practice Address - Street 1:115W 27TH ST 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6217
Practice Address - Country:US
Practice Address - Phone:312-852-7783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-01
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019433103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY019433OtherLICENSE