Healthcare Provider Details

I. General information

NPI: 1669670295
Provider Name (Legal Business Name): ELIZABETH MARMARAS PHD, EDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 ROUNDHOUSE RD
PIERMONT NY
10968
US

IV. Provider business mailing address

332 SPRINGFIELD AVE SUITE 204
SUMMIT NJ
07901
US

V. Phone/Fax

Practice location:
  • Phone: 201-247-2727
  • Fax:
Mailing address:
  • Phone: 908-522-1212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4135
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number015474
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35SI00413500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: