Individual
DR. PRADEEP D MARBALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8 NORTHAMPTON, ST MARYS HOSPITAL CHILDRENS MENTAL HEALTH CLINIC, AMSTERDAM, NY 12010
(518) 843-7520
(518) 843-7537
Mailing address
427 GUY PARK AVENUE, ST MARYS HOSPITAL BEHAVIORAL HEALTH, AMSTERDAM, NY 12010
(518) 843-7520
(518) 843-7537
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
178739
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02605356
—
NY
Enumeration date
11/22/2006
Last updated
07/08/2007
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