Provider Demographics
NPI:1255628376
Name:MARCUSE, JULIE JARETT (PHD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:JARETT
Last Name:MARCUSE
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 1:15 W 72ND ST
Mailing Address - Street 2:SUITE L-B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3402
Mailing Address - Country:US
Mailing Address - Phone:212-873-1414
Mailing Address - Fax:
Practice Address - Street 1:15 W 72ND ST
Practice Address - Street 2:SUITE L-B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3402
Practice Address - Country:US
Practice Address - Phone:212-873-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-10
Last Update Date:2011-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005397103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist