Individual
DR. MARILYN IRENE VENTULETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., ABSNP
Contact information
Practice address
120 BROADWAY, LYNBROOK, NY 11563-3233
(516) 887-4548
Mailing address
11 HARWICH RD, EAST ROCKAWAY, NY 11518-2407
(516) 887-4548
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
011535
NY
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
011535
NY
Other
Enumeration date
01/29/2007
Last updated
09/11/2025
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