Provider Demographics
NPI:1457403024
Name:DONNA GERARD MARDER L.C.S.W., P.C.
Entity Type:Organization
Organization Name:DONNA GERARD MARDER L.C.S.W., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:MARDER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-271-4514
Mailing Address - Street 1:2224 QUAKER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CROTON-ON-HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520
Mailing Address - Country:US
Mailing Address - Phone:914-271-4514
Mailing Address - Fax:413-337-4307
Practice Address - Street 1:2224 QUAKER RIDGE RD
Practice Address - Street 2:
Practice Address - City:CROTON-ON-HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520
Practice Address - Country:US
Practice Address - Phone:914-271-4514
Practice Address - Fax:413-337-4307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNYR0086331041C0700X
NYLCSWPR0086331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
N09701Medicare PIN