Healthcare Provider Details

I. General information

NPI: 1154196541
Provider Name (Legal Business Name): ANNE PERETTE DUBUISSON PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 11/16/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROCKLAND CHILDREN'S PSYCHIATRIC 2 FIRST AVE
ORANGEBURG NY
10962
US

IV. Provider business mailing address

3017 WICKHAM AVE
BRONX NY
10469-3217
US

V. Phone/Fax

Practice location:
  • Phone: 845-680-4000
  • Fax:
Mailing address:
  • Phone: 347-907-2868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number013536-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: