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General NPI Number Information
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NPI Number | 1851413256
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Entity Type | Individual
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Provider Name | KATHERINE MARNUCCI N.Y.S. LICENSES PSYC
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Gender | Female
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 02/20/2012
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Provider Practice Location Address
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Address Line | 175 EAST 96 STREET (APT 15K)
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-534-3332
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Fax |
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Provider Business Mailing Address
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Address Line | 175 EAST 96 STREET (APT 15K)
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 212-534-3332
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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 | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 000085
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 098000102
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN1843534
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License Number State | NY
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