DR. MARYBETH MACKIN (NPI# 1750467023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750467023 |
| Entity Type | Individual |
| Full Name | DR. MARYBETH MACKIN |
| Credential | PHD |
| Practice Address |
497 Broadway Room 2 Bayonne NJ 07002 |
| Practice Telephone | 2014374200 |
| Mailing Telephone | 2014374200 |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
10858 | NY | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
3214 | NJ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ LICENSE | 3214 | 01 | |
| NY LICENSE | 10858 | 01 |
| Street Address |
497 BROADWAY ROOM 2 |
| City | BAYONNE |
| State | NJ |
| Zip Code | 07002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447769690 | Medical Advocate Network | Clinic/Center | 497 Broadway, Suite 11, Bayonne, NJ 07002 | 2017-09-20 |
| 1679095871 | Rj Medical Services LLC | Durable Medical Equipment & Medical Supplies | 497 Broadway, Bayonne, NJ 07002-3710 | 2017-07-10 |
| 1851828024 | Rj Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 497 Broadway, Bayonne, NJ 07002-3710 | 2017-05-18 |
| 1679740294 | Edmund Francis Zalesky | Dentist | 497 Broadway, Suite 10, Bayonne, NJ 07002 | 2008-05-13 |
| 1851442594 | Ostrich Medical Transportation, LLC | Private Vehicle | 497 Broadway, Suite #11, Bayonne, NJ 07002-3710 | 2007-01-16 |
| 1053484519 | Valerie Anne Mitchell Fadil | Social Worker | 497 Broadway, Suite C, Bayonne, NJ 07002-3710 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205436029 | Nimitha Kumar | Dentist | 1216 John F Kennedy Blvd W, 2nd Floor, Bayonne, NJ 07002 | 2020-10-30 |
| 1972114437 | New Jersery Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 18-40 Goldsborough Drive, Bayonne, NJ 07002 | 2020-08-10 |
| 1134740707 | Paulanto Dental Clinic Corp | Clinic/Center | 189-195 Ave E, Bayonne, NJ 07002 | 2020-05-05 |
| 1093377152 | Moneeb Arshad Chohan | General Practice | 9 E 29th St, Bayonne, Bayonne, NJ 07002 | 2019-06-28 |
| 1477113835 | Jay Hwang | Dentist | 1160 John F. Kennedy Blvd, Suite B, Bayonne, NJ 07002 | 2019-06-18 |
| 1740845932 | Sara Shi | Student in an Organized Health Care Education/Training Program | Bayonne Medical Center, 29 E 29th St, Bayonne, NJ 07002 | 2019-05-03 |
| 1376003855 | S.akhtar.md.llc | Internal Medicine | 16 East 29th St, Bayonne, NJ 07002 | 2019-03-21 |
| 1144799701 | Perfect Home Care | Home Health | 473 Broadway Suite 402, Bayonne, NJ 07002 | 2018-11-13 |
| 1881174688 | Windmill Alliance Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 184 186 Hobart Avenue, Apartment #2, Bayonne, NJ 07002 | 2018-08-21 |
| 1437642774 | Agape Chen | Student in an Organized Health Care Education/Training Program | 29th Street & Avenue E, Bayonne, NJ 07002 | 2018-06-12 |
| Find all providers in zip 07002 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376862235 | Joel Nunez | Psychologist | 866 Broadway, Bayonne, NJ 07002-3070 | 2010-05-18 |
| 1578700969 | Robin Debra Golson | Psychologist | 325 Avenue C, Bayonne, NJ 07002-1403 | 2009-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750980371 | Eric Rose | Psychologist | 53 Audubon Rd, Teaneck, NJ 07666-5526 | 2020-10-23 |
| 1629682687 | Cbt Center of Central Nj | Psychologist | 16 Pearl Street, Suite 101 Cbt Center of Central Nj LLC, Metuchen, NJ 08840 | 2020-09-06 |
| 1891307955 | Julia Brillante | Psychologist | Center for Cognitive Behavior Therapy, 190 Route 18 North, Suite 203, East Brunswick, NJ 08816 | 2020-08-20 |
| 1659980944 | Lisa Spatafore | Psychologist | 2083 Lawrence Rd, Lawrenceville, NJ 08648-3001 | 2020-07-23 |
| 1821606054 | Glickman Psychological Services, LLC | Psychologist | 80 Barclay Center, Suite 4, Cherry Hill, NJ 08034 | 2020-07-14 |
| 1952927634 | Gordon Presley | Psychologist | 317 George St. Suite 320, New Brunswick, NJ 08901-2091 | 2020-06-18 |
| 1659996692 | Thrive Psychology Center, LLC | Psychologist | 699 Cross St Ste 110, Lakewood, NJ 08701-4681 | 2020-06-16 |
| 1871117499 | Haven Psychotherapy LLC | Psychologist | 25 Terrell Rd, Lambertville, NJ 08530-3428 | 2020-05-29 |
| 1447873781 | Elements Psychological Services, LLC | Psychologist | 36 Cottage Ln, Upper Saddle River, NJ 07458-1306 | 2020-05-21 |
| 1285255398 | Amanda Addolorato Macdonald | Psychologist | 12 2nd St, Hackensack, NJ 07601-2009 | 2020-04-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.