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NPI Code Detail

MEDICARE: MADELEINE TERRY PHD

MEDICARE: MADELEINE TERRY PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2103TC0700XClinical Psychologist023434NY

General Provider Information

NPI Number : 1144609298
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELEINE TERRY PHD
Provider Business Mailing Address
First Line : 99 FORT WASHINGTON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10032-4655
Country : US
Telephone Number : 646-317-5718
Fax Number :
Provider Business Practice Location Address
First Line : 99 FORT WASHINGTON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10032-4655
Country : US
Telephone Number : 646-317-5718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2015
Last Update Date : 10/06/2019

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Directions to “ MADELEINE TERRY PHD” Practice Location

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