Provider Demographics
NPI:1447586862
Name:MACEDONIO, MARY F (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:MACEDONIO
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:44 COURT ST. SUITE 1217 PMB 90760
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4410
Mailing Address - Country:US
Mailing Address - Phone:877-978-9877
Mailing Address - Fax:800-881-4115
Practice Address - Street 1:31 COMMERCIAL CT
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-2403
Practice Address - Country:US
Practice Address - Phone:646-239-8210
Practice Address - Fax:800-881-4115
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-19
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY018162103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty