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General NPI Number Information
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NPI Number | 1205148814
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Entity Type | Individual
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Provider Name | MARIA NICOLE MARCHESE-MAZZEO PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 2002 NEW YORK AVE
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City | UNION CITY
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State | NJ
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Zip | 07087-4431
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Country | US
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Telephone | 201-647-4578
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Fax | 201-865-3867
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Provider Business Mailing Address
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Address Line | 600 HARBOR BLVD UNIT # 925
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City | WEEHAWKEN
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State | NJ
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Zip | 07086-6746
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Country | US
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Telephone | 201-647-4578
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Fax | 201-865-3867
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 016414
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License Number State | NY
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