Provider Demographics
NPI:1457402521
Name:MARCOTTE, ANN CAROL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:CAROL
Last Name:MARCOTTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:130 W 15TH ST
Mailing Address - Street 2:APARTMENT 12F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6733
Mailing Address - Country:US
Mailing Address - Phone:212-807-1232
Mailing Address - Fax:212-326-8590
Practice Address - Street 1:16 E 60TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1002
Practice Address - Country:US
Practice Address - Phone:212-326-8441
Practice Address - Fax:212-326-8590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY015142-1103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVM9591Medicare UPIN