Healthcare Provider Details

I. General information

NPI: 1093849358
Provider Name (Legal Business Name): MARIE-GENEVIEVE ISELIN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 W 9TH ST SUITE 2C
NEW YORK NY
10011-8971
US

IV. Provider business mailing address

7-13 WASHINGTON SQ N APT. 7
NEW YORK NY
10003-6623
US

V. Phone/Fax

Practice location:
  • Phone: 212-228-2898
  • Fax: 212-228-2898
Mailing address:
  • Phone: 212-998-2898
  • Fax: 212-228-2898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number16589
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: