| Christine A Marra Psychologist Pllc | |
|
1 Marcus Blvd Ste. 105 Albany NY 12205-5953 | |
| (518) 587-0499 | |
| (518) 786-6467 |
| Full Name | Christine A Marra Psychologist Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 1 Marcus Blvd, Albany, New York |
| Authorized Official Name and Position | Christine A Marra (SOLE MEMBER) |
| Authorized Official Contact | 5185870499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christine A Marra Psychologist Pllc 55 S Angell St Providence RI 02906-5206 Ph: (518) 587-0499 | Christine A Marra Psychologist Pllc 1 Marcus Blvd Ste. 105 Albany NY 12205-5953 Ph: (518) 587-0499 |
| NPI Number | 1851636104 |
|---|---|
| Provider Enumeration Date | 11/27/2012 |
| Last Update Date | 08/13/2015 |
| Medicare PECOS PAC ID | 1759534605 |
|---|---|
| Medicare Enrollment ID | O20190521000902 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851636104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 014506-1 (New York) | Primary |
| Provider Name | Christine A Marra |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043238785 PECOS PAC ID: 5092868133 Enrollment ID: I20090806000422 |
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