Provider Demographics
NPI:1841833969
Name:INNERWISDOM PSYCHOLOGICAL SERVICES PC
Entity type:Organization
Organization Name:INNERWISDOM PSYCHOLOGICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARMARAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ABPPP
Authorized Official - Phone:917-589-9385
Mailing Address - Street 1:119 W 57TH ST STE 516
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2302
Mailing Address - Country:US
Mailing Address - Phone:917-589-9385
Mailing Address - Fax:
Practice Address - Street 1:119 W 57TH ST STE 516
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2302
Practice Address - Country:US
Practice Address - Phone:917-589-9385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty