Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Mary Eugenia Theodore, MDMPH

Individual provider Psychiatry Physician · NPI 1063675700

Dr. Mary Eugenia Theodore, MDMPH is a Psychiatry Physician in New York, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2008

Practice location Address checks out

31 W 12th St Ste 1E
New York, NY 10011-8500 Not confirmed with CMS for 18 years — call before visiting
Phone: (212) 255-4364
Fax: (212) 255-4364
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 1930391 (NY)

Record details

NPI number1063675700
Entity typeIndividual (Type 1)
GenderFemale
Credentials MDMPH
Sole proprietorYes
NPI enumeratedJuly 2, 2008
Last updated in NPPESJuly 2, 2008

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