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General NPI Number Information
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NPI Number | 1700316619
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Entity Type | Individual
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Provider Name | MARY V. MINGES PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 140 W 86TH ST # 1B
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City | NEW YORK
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State | NY
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Zip | 10024-4034
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Country | US
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Telephone | 212-979-1287
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Fax |
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Provider Business Mailing Address
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Address Line | 200 CABRINI BLVD APT 87
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City | NEW YORK
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State | NY
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Zip | 10033-1121
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Country | US
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Telephone | 212-979-1287
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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 | 023864
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License Number State | NY
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