Provider Demographics
NPI:1972652329
Name:SCOTZIN, MARTHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:SCOTZIN
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 1:276 FIFTH AVENUE
Mailing Address - Street 2:SUITE 507B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-684-1946
Mailing Address - Fax:212-685-3831
Practice Address - Street 1:276 FIFTH AVENUE
Practice Address - Street 2:SUITE 507B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-684-1946
Practice Address - Fax:212-685-3831
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X, 103TB0200X, 103TC1900X
NYNY LIC. 010815-1103T00000X
PAPS003026-L103T00000X
NY010815-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV95171Medicare UPIN
NYV95171Medicare ID - Type Unspecified