Individual
MARILYN BLUMENTHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
30 CLAFFORD LN, MELVILLE, NY 11747-1310
(631) 351-4749
Mailing address
30 CLAFFORD LN, MELVILLE, NY 11747-1310
(631) 351-4749
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5250
NY
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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