Individual
DR. MARY EUGENIA THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
31 W 12TH ST, SUITE 1E, NEW YORK, NY 10011-8500
(212) 255-4364
(212) 255-4364
Mailing address
31 WEST 12TH STREET, SUITE 1E, NEW YORK, NY 10011
(212) 255-4364
(212) 255-4364
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1930391
NY
Other
Enumeration date
07/02/2008
Last updated
07/02/2008
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