Provider Demographics
NPI:1023178415
Name:MARGUERAT DEGAARD, FANCHETTE J (PHD)
Entity type:Individual
Prefix:
First Name:FANCHETTE
Middle Name:J
Last Name:MARGUERAT DEGAARD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:40 STEPHENS DR
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-6111
Mailing Address - Country:US
Mailing Address - Phone:914-372-7673
Mailing Address - Fax:
Practice Address - Street 1:280 MADISON AVE RM 205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0816
Practice Address - Country:US
Practice Address - Phone:917-733-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017476-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical