Provider Demographics
NPI:1831322080
Name:GENKINS, MARY E (DSW, CSW, PC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:E
Last Name:GENKINS
Suffix:
Gender:F
Credentials:DSW, CSW, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 E 63RD ST
Mailing Address - Street 2:12L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7918
Mailing Address - Country:US
Mailing Address - Phone:212-838-9257
Mailing Address - Fax:212-207-6615
Practice Address - Street 1:430 E 63RD ST
Practice Address - Street 2:12L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7918
Practice Address - Country:US
Practice Address - Phone:212-838-9257
Practice Address - Fax:212-207-6615
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0202361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical