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General NPI Number Information
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NPI Number | 1861960759
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Entity Type | Individual
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Provider Name | YULY ELIZABETH THOMAS
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Gender | Female
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Dates
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Enumeration Date | 11/08/2018
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 163 W 125TH ST FL 12
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City | NEW YORK
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State | NY
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Zip | 10027-4436
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Country | US
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Telephone | 212-961-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 840 THROGGS NECK EXPY
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City | BRONX
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State | NY
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Zip | 10465-1650
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Country | US
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Telephone | 917-770-2979
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 002020
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License Number State | NY
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