Individual
PROF. MARITZAM MARICE MCCONNEGHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1138 229TH DR S, BRONX, NY 10466-5119
(718) 992-1573
(347) 665-1477
Mailing address
1138 229TH DR S, 6G, BRONX, NY 10466-5119
(347) 449-6790
(347) 665-1477
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NY
222Q00000X
Developmental Therapist
Primary
2030100
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02799640
—
NY
01
—
40948101
USMLE
NY
Enumeration date
12/21/2007
Last updated
03/07/2023
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