MEDICARE: DR. EVELYN RIVIA LIEF PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	102L00000X	Psychoanalyst	(19) 000088	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4205707	OTHER	NY	AETNA
2	P1300908	OTHER	NY	OXFORD
3	9449093	OTHER	NY	PHCS

General Provider Information

NPI Number	:	1730235441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVELYN RIVIA LIEF PH.D.

Provider Business Mailing Address
First Line	:	326 COLUMBUS AVENUE
Second Line	:	APT 6F
City	:	NEW YORK
State	:	NY
Zip	:	10023-8446
Country	:	US
Telephone Number	:	212-362-0536
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 COLUMBUS AVENUE
Second Line	:	APT 6F
City	:	NEW YORK
State	:	NY
Zip	:	10023-8446
Country	:	US
Telephone Number	:	212-362-0536
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. EVELYN RIVIA LIEF PH.D.” Practice Location

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