Healthcare Provider Details

I. General information

NPI: 1972652329
Provider Name (Legal Business Name): MARTHA SCOTZIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

276 FIFTH AVENUE SUITE 507B
NEW YORK NY
10016
US

IV. Provider business mailing address

276 FIFTH AVENUE SUITE 507B
NEW YORK NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 212-684-1946
  • Fax: 212-685-3831
Mailing address:
  • Phone: 212-684-1946
  • Fax: 212-685-3831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberNY LIC. 010815-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS003026-L
License Number StatePA
# 5
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number010815-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: