Healthcare Provider Details

I. General information

NPI: 1083748313
Provider Name (Legal Business Name): ANA DYBNER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 04/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 3RD AVE STE 201
NEW YORK NY
10128-3638
US

IV. Provider business mailing address

11 E 86TH ST APT 4C
NEW YORK NY
10028-0501
US

V. Phone/Fax

Practice location:
  • Phone: 917-843-6284
  • Fax:
Mailing address:
  • Phone: 212-722-8889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number010668-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: