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General NPI Number Information
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NPI Number | 1477827533
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Entity Type | Organization
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Legal Business Name | ELYSE DUBIN MD PC
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 3 EAST 10TH STREET UNIT BR1
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-777-0014
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Fax |
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Provider Business Mailing Address
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Address Line | 3 EAST 10TH STREET UNIT BR1
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-777-0014
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Fax |
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Authorized Official
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Title or Position | PRIVATE PRACTITIONER
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Name | ELYSE DUBIN
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Credential |
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Telephone | 212-777-0014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 140357
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License Number State | NY
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