Provider Demographics
NPI:1285898866
Name:WIENER MARGULIES, MARIAN (PHD)
Entity type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:
Last Name:WIENER MARGULIES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 ROCKINGSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1514
Mailing Address - Country:US
Mailing Address - Phone:914-384-5544
Mailing Address - Fax:
Practice Address - Street 1:203 ROCKINGSTONE AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-1514
Practice Address - Country:US
Practice Address - Phone:914-384-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012020103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent