Provider Demographics
NPI:1912473737
Name:GARNICK, MARGOT
Entity Type:Individual
Prefix:
First Name:MARGOT
Middle Name:
Last Name:GARNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4119 41ST ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3209
Mailing Address - Country:US
Mailing Address - Phone:646-543-2623
Mailing Address - Fax:
Practice Address - Street 1:1841 BROADWAY FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:212-333-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP13747106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist