Provider Demographics
NPI:1710101662
Name:PASTER, MARY ROSE QUINN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY ROSE
Middle Name:QUINN
Last Name:PASTER
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 1:105 LATTINGTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1200
Mailing Address - Country:US
Mailing Address - Phone:516-676-8675
Mailing Address - Fax:
Practice Address - Street 1:105 LATTINGTOWN RD
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-1200
Practice Address - Country:US
Practice Address - Phone:516-676-8675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007073-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist