Provider Demographics
NPI:1740425636
Name:ANDREWS, MARY BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY BETH
Middle Name:
Last Name:ANDREWS
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 1:169 BEACH 132ND ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1407
Mailing Address - Country:US
Mailing Address - Phone:646-220-7007
Mailing Address - Fax:718-634-8432
Practice Address - Street 1:4533 MARATHON PKWY
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1253
Practice Address - Country:US
Practice Address - Phone:646-220-7007
Practice Address - Fax:718-634-8432
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011671103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical