Provider Demographics
NPI:1477821213
Name:MADDEN SZESZKO, GLORIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:MADDEN SZESZKO
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:ONE MOUNT HOPE BLVD.
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NY
Mailing Address - Zip Code:10706-2408
Mailing Address - Country:US
Mailing Address - Phone:914-478-6203
Mailing Address - Fax:
Practice Address - Street 1:1 MOUNT HOPE BLVD
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-2408
Practice Address - Country:US
Practice Address - Phone:914-478-6203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0148761103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist