Provider Demographics
NPI:1659017101
Name:MARGUERAT DEGAARD PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:MARGUERAT DEGAARD PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FANCHETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGUERAT DEGAARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:917-773-0961
Mailing Address - Street 1:923 SAW MILL RIVER RD # 226
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-1106
Mailing Address - Country:US
Mailing Address - Phone:917-733-0961
Mailing Address - Fax:
Practice Address - Street 1:280 MADISON AVE RM 205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0816
Practice Address - Country:US
Practice Address - Phone:917-733-0961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty