Healthcare Provider Details

I. General information

NPI: 1831240878
Provider Name (Legal Business Name): ELANA DIANE RIMLER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 MELROSE RD
DIX HILLS NY
11746-5623
US

IV. Provider business mailing address

56 MELROSE RD
DIX HILLS NY
11746-5623
US

V. Phone/Fax

Practice location:
  • Phone: 917-833-5069
  • Fax:
Mailing address:
  • Phone: 631-659-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number016965
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number016965-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: