MEDICARE: DONNA MARSHALL M.A.ED.M

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

General Provider Information

NPI Number	:	1992167258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA MARSHALL M.A.ED.M

Provider Business Mailing Address
First Line	:	2 BEEKMAN PL
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-8016
Country	:	US
Telephone Number	:	212-421-3359
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 E 72ND ST
Second Line	:	SUITE 1C
City	:	NEW YORK
State	:	NY
Zip	:	10021-4553
Country	:	US
Telephone Number	:	212-472-8507
Fax Number	:

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

Provider Enumeration Date	:	03/25/2016
Last Update Date	:	03/25/2016

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