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General NPI Number Information
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NPI Number | 1477699296
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Entity Type | Individual
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Provider Name | MARSHA TRACY ANN AUSTIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 04/07/2014
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Provider Practice Location Address
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Address Line | 180 LIVINGSTON STREET
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City | BROOKLYN
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State | NY
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Zip | 11201
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Country | US
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Telephone | 917-485-7441
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Fax |
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Provider Business Mailing Address
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Address Line | 138-32 229 STREET
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City | LAURELTON
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State | NY
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Zip | 11413
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Country | US
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Telephone | 718-598-5636
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 248968
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | AJ4147357
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License Number State | MD
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