Healthcare Provider Details

I. General information

NPI: 1407925001
Provider Name (Legal Business Name): MARY PAIZIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1879 MADISON AVE 6TH FLR
NEW YORK NY
10035-2709
US

IV. Provider business mailing address

1879 MADISON AVE 6TH FLR
NEW YORK NY
10035-2709
US

V. Phone/Fax

Practice location:
  • Phone: 212-423-4500
  • Fax: 212-423-1404
Mailing address:
  • Phone: 212-423-4500
  • Fax: 212-423-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number216025
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: