Provider Demographics
NPI:1386865590
Name:MARGOLIES, PAUL JEFFREY (PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JEFFREY
Last Name:MARGOLIES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 SMITH AVENUE
Mailing Address - Street 2:
Mailing Address - City:MT. KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-666-3520
Mailing Address - Fax:
Practice Address - Street 1:91 SMITH AVENUE
Practice Address - Street 2:
Practice Address - City:MT. KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-666-3520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6692103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV54821Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST