Healthcare Provider Details

I. General information

NPI: 1447285945
Provider Name (Legal Business Name): MARISA PISANI KOTEN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 11/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 UNIVERSITY PL 4TH FLOOR
NEW YORK NY
10003-4528
US

IV. Provider business mailing address

207 E 31ST ST
NEW YORK NY
10016-6302
US

V. Phone/Fax

Practice location:
  • Phone: 212-252-2487
  • Fax: 212-779-2444
Mailing address:
  • Phone: 212-779-2277
  • Fax: 212-779-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number015003
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: