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General NPI Number Information
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NPI Number | 1902359177
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Entity Type | Individual
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Provider Name | MARALYS COLON BETANCOURT MD
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Gender | Female
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Dates
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Enumeration Date | 07/25/2016
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 250 PARKWAY DR STE 150
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-4340
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Country | US
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Telephone | 833-351-8255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24449
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City | NEW YORK
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State | NY
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Zip | 10087-0589
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Country | US
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Telephone | 833-351-8255
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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 | 332203
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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 | 036171479
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD487133
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01087793A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 326216
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License Number State | LA
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