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NPI Code Detail

MEDICARE: EMILY DVORAK PHD

MEDICARE: EMILY DVORAK 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
1103G00000XClinical Neuropsychologist

General Provider Information

NPI Number : 1235062555
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY DVORAK PHD
Provider Business Mailing Address
First Line : 525 E 68TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10065-4870
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 525 E 68TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10065-4870
Country : US
Telephone Number : 212-746-4666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2026
Last Update Date : 06/05/2026

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