Individual
DR. MARIANNE W TATEOSIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
500 COMMACK RD STE 105, COMMACK, NY 11725-5020
(631) 632-9510
(631) 216-8319
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-0650
(631) 638-4170
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
268594-1
NY
2084P0804X
Child & Adolescent Psychiatry Physician
68136
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/04/2009
Last updated
08/04/2020
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