=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396718433
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | IONA H. GINSBURG MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/09/2006
-----------------------------------------------------
Last Update Date | 07/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 55 EAST 86TH ST. APT 16 C
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10028-1059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-289-5050
-----------------------------------------------------
Fax | 212-289-5051
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 55 EAST 86TH ST. APT 16 C
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10028-1059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-289-5050
-----------------------------------------------------
Fax | 212-289-5051
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 081871
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | MD081871
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------