Healthcare Provider Details

I. General information

NPI: 1235080946
Provider Name (Legal Business Name): LUCY DYBISZ PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2026
Last Update Date: 03/22/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 WAVERLY AVE APT SPH3
MAMARONECK NY
10543-1894
US

IV. Provider business mailing address

270 WAVERLY AVE APT SPH3
MAMARONECK NY
10543-1894
US

V. Phone/Fax

Practice location:
  • Phone: 914-584-9659
  • Fax:
Mailing address:
  • Phone: 914-584-9659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11046151
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberF408025
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: