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General NPI Number Information
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NPI Number | 1871846733
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Entity Type | Individual
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Provider Name | ELYSE J BENSUSAN PSY.D
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Gender | Female
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 1751 2ND AVENUE SUITE A2-5
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City | NEW YORK
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State | NY
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Zip | 10128
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Country | US
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Telephone | 917-440-2827
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Fax |
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Provider Business Mailing Address
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Address Line | 420 EAST 61 STREET SUITE 34B
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City | NEW YORK
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State | NY
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Zip | 10065
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Country | US
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Telephone | 917-440-2827
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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