Healthcare Provider Details

I. General information

NPI: 1831877539
Provider Name (Legal Business Name): SHIRA LEVY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHIRA DREYFUSS

II. Dates (important events)

Enumeration Date: 07/11/2023
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 3RD AVE APT 29J
NEW YORK NY
10128-3643
US

IV. Provider business mailing address

1623 3RD AVE APT 29J
NEW YORK NY
10128-3643
US

V. Phone/Fax

Practice location:
  • Phone: 516-361-3987
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP146368
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: