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General NPI Number Information
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NPI Number | 1447445713
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Entity Type | Organization
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Legal Business Name | CORREA & PEVERLY PSYCHOLOGISTS, PC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 2 BRAMBACH AVE
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City | SCARSDALE
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State | NY
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Zip | 10583-5236
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Country | US
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Telephone | 914-646-2472
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Fax | 914-693-7808
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Provider Business Mailing Address
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Address Line | 42 CHESTNUT RIDGE WAY
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City | DOBBS FERRY
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State | NY
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Zip | 10522-3216
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Country | US
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Telephone | 914-646-2472
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Fax | 914-693-7808
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTHA L CORREA-PEVERLY
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Credential | PH.D.
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Telephone | 212-865-5899
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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 | 011942-1
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License Number State | NY
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