MEDICARE: DR. CONNIE MARIA DEPINHO 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
1	103TC0700X	Clinical Psychologist	0109571	NY

General Provider Information

NPI Number	:	1619057890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CONNIE MARIA DEPINHO PHD

Provider Business Mailing Address
First Line	:	1392 ALBANY POST RD
Second Line	:
City	:	CROTON ON HUDSON
State	:	NY
Zip	:	10520-1559
Country	:	US
Telephone Number	:	914-923-3767
Fax Number	:	914-827-9334

Provider Business Practice Location Address
First Line	:	1392 ALBANY POST RD
Second Line	:
City	:	CROTON ON HUDSON
State	:	NY
Zip	:	10520-1559
Country	:	US
Telephone Number	:	914-923-3767
Fax Number	:	914-827-9334

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/18/2023

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