MEDICARE: DR. DEBBIE M MAGIDS PH.D.

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
1	102L00000X	Psychoanalyst	012716-1	NY

General Provider Information

NPI Number	:	1255543567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBBIE M MAGIDS PH.D.

Provider Business Mailing Address
First Line	:	155 W 21ST ST APT 5G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011
Country	:	US
Telephone Number	:	646-369-2488
Fax Number	:

Provider Business Practice Location Address
First Line	:	96 5TH AVE APT 1K
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-7604
Country	:	US
Telephone Number	:	646-369-2488
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	11/26/2007

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