Provider Demographics
NPI:1780747113
Name:PALEY, MARLENE GERSHMAN
Entity type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:GERSHMAN
Last Name:PALEY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:MARLENE
Other - Middle Name:GERSHMAN
Other - Last Name:PALEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:7 EASTWOODS DR
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11724-2303
Mailing Address - Country:US
Mailing Address - Phone:631-423-6932
Mailing Address - Fax:
Practice Address - Street 1:7 EASTWOODS DR
Practice Address - Street 2:
Practice Address - City:COLD SPRING HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11724-2303
Practice Address - Country:US
Practice Address - Phone:631-423-6932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000363103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis