Provider Demographics
NPI:1821200213
Name:CUSTOMER MARKETING GROUP
Entity Type:Organization
Organization Name:CUSTOMER MARKETING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:203-247-4669
Mailing Address - Street 1:7 HILL FARM RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-2006
Mailing Address - Country:US
Mailing Address - Phone:203-226-8993
Mailing Address - Fax:203-226-9837
Practice Address - Street 1:165 E 89TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2315
Practice Address - Country:US
Practice Address - Phone:212-860-0296
Practice Address - Fax:203-226-9837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007625-1103TC0700X, 103TF0000X
CT001997103TC0700X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty