Healthcare Provider Details

I. General information

NPI: 1942104617
Provider Name (Legal Business Name): ELIZABETH CONGIUSTA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 20TH ST STE 3C
BROOKLYN NY
11232-1254
US

IV. Provider business mailing address

225 E 86TH ST APT 303
NEW YORK NY
10028-3068
US

V. Phone/Fax

Practice location:
  • Phone: 718-635-0518
  • Fax:
Mailing address:
  • Phone: 518-915-5089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number68-P145010-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: