Healthcare Provider Details

I. General information

NPI: 1104598051
Provider Name (Legal Business Name): MARIA NEIERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 LEXINGTON AVE FL 10
NEW YORK NY
10016-6020
US

IV. Provider business mailing address

215 E 68TH ST APT 2Z
NEW YORK NY
10065-5719
US

V. Phone/Fax

Practice location:
  • Phone: 212-335-0034
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number028415
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35SI00820000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009335
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: