Healthcare Provider Details

I. General information

NPI: 1982792644
Provider Name (Legal Business Name): MARY KATHERINE BEHLING MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S JERSEY AVE SUITE 33
EAST SETAUKET NY
11733-2034
US

IV. Provider business mailing address

100 S JERSEY AVE SUITE 33
EAST SETAUKET NY
11733-2034
US

V. Phone/Fax

Practice location:
  • Phone: 631-689-2500
  • Fax: 631-689-5535
Mailing address:
  • Phone: 631-689-2500
  • Fax: 631-689-5535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number158981
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: