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NPI Code Detail

MEDICARE: DR. KARISSA YSABEL LIM PHD

MEDICARE: DR. KARISSA YSABEL LIM PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist027804NY

General Provider Information

NPI Number : 1154284784
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KARISSA YSABEL LIM PHD
Provider Business Mailing Address
First Line : 1 N BROADWAY STE 704
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10601-2320
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 N BROADWAY STE 704
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10601-2320
Country : US
Telephone Number : 914-385-1150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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