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Mary Kathleen Martin Nurse Practitioner In Psychiatry, Pllc
Prescribing (Medical) Psychologist in Riverhead, New York
NPI 1578921623

Mary Kathleen Martin Nurse Practitioner In Psychiatry, Pllc is a Prescribing (Medical) Psychologist based in Mattituck, NY and is specialized in Prescribing (Medical). Mary Kathleen Martin Nurse Practitioner In Psychiatry, Pllc practices in Riverhead, NY. The NPI Number for Mary Kathleen Martin Nurse Practitioner In Psychiatry, Pllc is 1578921623 and holds a License No. 401909 (New York).

The current practice location address for Mary Kathleen Martin Nurse Practitioner In Psychiatry, Pllc is 21 W 2Nd St, Riverhead, NY and can be reached out via phone at 631-624-7839 and via fax at 631-865-5857.

Location: 21 W 2Nd St, Riverhead, NY, 11952-2079
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1578921623
Provider Name
Mary Kathleen Martin Nurse Practitioner In Psychiatry, Pllc
Credential
Provider Entity Type
Organization
Address
21 W 2Nd St, Riverhead, NY, 11952-2079
Phone Number
631-624-7839
Fax Number
631-865-5857
Provider Enumeration Date
02/04/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
13554525 01 NY CAQH
institution
Provider Business Practice Location Address Details
Address
21 W 2Nd St
City
Riverhead
State
New York
Zip
11901-2752
Phone Number
631-624-7839
Fax Number
631-865-5857
person
Provider Business Mailing Address Details
Address
21 W 2Nd St
City
Riverhead
State
New York
Zip
11901-2752
Phone Number
631-624-7839
Fax Number
631-865-5857
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Prescribing (Medical)
Taxonomy
103TP0016X
License No.
401909 (New York)
Definition
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
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