Organization
NELLY STA MARIA PSYCHOLOGIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELLY L STA MARIA PH.D. (CLINICAL PSYCHOLOGIST)
(646) 895-0794
Entity
Organization
Contact information
Practice address
19 W 34TH ST, PH, NEW YORK, NY 10001-3006
(212) 947-7111
Mailing address
57 DOLPHIN LN E, COPIAGUE, NY 11726-5415
(646) 895-0794
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
017642
NY
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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