Provider Demographics
NPI:1902437973
Name:SCHOENHAMMER, MARIA OTTILIE (PHD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:OTTILIE
Last Name:SCHOENHAMMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:SCHONHAMMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:518 W 142ND ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-6701
Mailing Address - Country:US
Mailing Address - Phone:646-415-1940
Mailing Address - Fax:
Practice Address - Street 1:156 W 56TH ST STE 1804
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3878
Practice Address - Country:US
Practice Address - Phone:212-851-8100
Practice Address - Fax:888-977-2547
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023645103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY023645OtherLICENSE