MEDICARE: MS. LAVINIA MARCHIS

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	103TB0200X	Cognitive & Behavioral Psychologist	021975	NY

General Provider Information

NPI Number	:	1942634928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAVINIA MARCHIS

Provider Business Mailing Address
First Line	:	14 RYE RIDGE PLZ STE 236
Second Line	:
City	:	RYE BROOK
State	:	NY
Zip	:	10573-2858
Country	:	US
Telephone Number	:	203-514-2405
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 RYE RIDGE PLZ STE 236
Second Line	:
City	:	RYE BROOK
State	:	NY
Zip	:	10573-2858
Country	:	US
Telephone Number	:	203-514-2405
Fax Number	:

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

Provider Enumeration Date	:	08/27/2013
Last Update Date	:	03/17/2018

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