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General NPI Number Information
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NPI Number | 1245328046
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Entity Type | Individual
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Provider Name | MARSHALL S FENSTER PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7301 W PALMETTO PARK RD SUITE 208-A
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City | BOCA RATON
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State | FL
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Zip | 33433-3458
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Country | US
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Telephone | 561-395-4422
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Fax |
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Provider Business Mailing Address
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Address Line | 7301 W PALMETTO PARK RD SUITE 208-A
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City | BOCA RATON
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State | FL
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Zip | 33433-3458
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Country | US
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Telephone | 561-395-4422
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Fax |
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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 | PY4991
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License Number State | FL
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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 | 011658-1
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License Number State | NY
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