Provider Demographics
NPI:1922163740
Name:TURNOCK, MARY-THOMAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY-THOMAS
Middle Name:
Last Name:TURNOCK
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 1:152 VALLEY STREAM RD E
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1743
Mailing Address - Country:US
Mailing Address - Phone:914-834-3889
Mailing Address - Fax:914-834-3889
Practice Address - Street 1:23 OLD MAMARONECK RD
Practice Address - Street 2:STE 2
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2061
Practice Address - Country:US
Practice Address - Phone:914-834-3889
Practice Address - Fax:914-834-3889
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007668-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02262788Medicaid
NY02262788Medicaid