Provider Demographics
NPI:1619057890
Name:DEPINHO, CONNIE MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:MARIA
Last Name:DEPINHO
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 1:1392 ALBANY POST RD
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-1559
Mailing Address - Country:US
Mailing Address - Phone:914-923-3767
Mailing Address - Fax:914-827-9334
Practice Address - Street 1:1392 ALBANY POST RD
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-1559
Practice Address - Country:US
Practice Address - Phone:914-923-3767
Practice Address - Fax:914-827-9334
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0109571103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV0C041Medicare ID - Type Unspecified