Provider Demographics
NPI:1134324767
Name:BLECKER, MARCIA Z (NCPSYA, JD, MA)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:Z
Last Name:BLECKER
Suffix:
Gender:F
Credentials:NCPSYA, JD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BAYBERRY RDG
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-1330
Mailing Address - Country:US
Mailing Address - Phone:516-365-7180
Mailing Address - Fax:
Practice Address - Street 1:594 BROADWAY
Practice Address - Street 2:ALFRED ADLER INSTITUTE -- SUITE 1213
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3233
Practice Address - Country:US
Practice Address - Phone:516-639-8490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000405102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst