Healthcare Provider Details

I. General information

NPI: 1881743466
Provider Name (Legal Business Name): MARY SWIFT FOOTE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 E 78TH ST SUITE 4A
NEW YORK NY
10021-0211
US

IV. Provider business mailing address

49 E 78TH ST SUITE 4A
NEW YORK NY
10021-0211
US

V. Phone/Fax

Practice location:
  • Phone: 212-628-8256
  • Fax: 212-452-0080
Mailing address:
  • Phone: 212-628-8256
  • Fax: 212-452-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number011439-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: