Individual provider Active NPI

Patria V Marin, PHD

  • Psychologist
  • Bronx, NY
National Provider Identifier
1720049075
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018028 Issued in NY
Practice address
25 E 183Rd St
Bronx, NY 10453-1242
Phone
(718) 839-8900
Fax
(718) 839-8989
NPI assigned
Mar 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Psychologist 103T00000X 018028 NY Primary

Addresses

Primary practice location

25 E 183Rd St
Bronx, NY 10453-1242

Mailing address

117 West 13TH Street
Suite 1
New York, NY 10011
Phone (646) 633-2336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121009000008 NY Practitioner - Clinical Psychologist 5496912297 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
018028NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Hargrove MD PLLC CurrentSince Oct 18, 2024 Accepting new patients
Supportive Care Psychology of Ny PC CurrentSince Dec 15, 2025 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200

170 Lake St
Liberty, NY 12754
Phone (845) 292-4200

330 Chestnut St
Oneonta, NY 13820
Phone (607) 432-8500

3505 Hill Blvd
Ste K
Yorktown Heights, NY 10598
Phone (914) 245-3303

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1720049075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST 13TH STREET",
            "address_2": "SUITE 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "646-633-2336",
            "fax_number": "212-560-0936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E 183RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104531242",
            "telephone_number": "718-839-8900",
            "fax_number": "718-839-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "PATRIA",
        "middle_name": "V",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.