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General NPI Number Information
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NPI Number | 1306011457
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Entity Type | Individual
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Provider Name | MARGARET GERALDINE KAVANAU PHD
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Gender | Female
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 1120 PARK AVENUE
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City | NEW YORK
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State | NY
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Zip | 10128-1242
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Country | US
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Telephone | 212-665-7691
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Fax |
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Provider Business Mailing Address
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Address Line | 306 WEST 105 STREET APT #5
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City | NEW YORK
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State | NY
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Zip | 10025-3414
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Country | US
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Telephone | 212-665-7691
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0098981
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License Number State | NY
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