Provider Demographics
NPI:1649399510
Name:COMMERFORD, MARY CATHERINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CATHERINE
Last Name:COMMERFORD
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 1:180 COW NECK RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1102
Mailing Address - Country:US
Mailing Address - Phone:516-944-6792
Mailing Address - Fax:
Practice Address - Street 1:666 W END AVE
Practice Address - Street 2:APT 9-W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7357
Practice Address - Country:US
Practice Address - Phone:212-501-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012270-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical