Provider Demographics
NPI:1598307704
Name:ARISTILDE, MARIE VIRGINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:VIRGINE
Last Name:ARISTILDE
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 1:19 ERNEST CT
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-5020
Mailing Address - Country:US
Mailing Address - Phone:516-504-5074
Mailing Address - Fax:
Practice Address - Street 1:19 ERNEST CT
Practice Address - Street 2:
Practice Address - City:KINGS PARK
Practice Address - State:NY
Practice Address - Zip Code:11754-5020
Practice Address - Country:US
Practice Address - Phone:516-504-5074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist