Provider Demographics
NPI:1992167258
Name:MARSHALL, DONNA (MAEDM)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:MAEDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BEEKMAN PL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-8016
Mailing Address - Country:US
Mailing Address - Phone:212-421-3359
Mailing Address - Fax:
Practice Address - Street 1:245 E 72ND ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4553
Practice Address - Country:US
Practice Address - Phone:212-472-8507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst