MEDICARE: EKATERINA ZUBRITSKAYA PA, PH.D

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	17511	NY
2	102L00000X	Psychoanalyst	000942-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000941-1	OTHER	NY	THE UNIVERSITY OF THE STATE OF NEW YORK, PSYCHOANALYST LICENSE
2	8978881	OTHER	NY	REGISTRATION CERTIFICATE FOR THE LICENSE OF PSYCHOANALIST

General Provider Information

NPI Number	:	1508048810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EKATERINA ZUBRITSKAYA PA, PH.D

Provider Business Mailing Address
First Line	:	815 E 14TH ST APT 4C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-2946
Country	:	US
Telephone Number	:	917-770-8727
Fax Number	:

Provider Business Practice Location Address
First Line	:	1841 BROADWAY FL 4
Second Line	:	5 WEST 86TH STREET, SUITE 1C
City	:	NEW YORK
State	:	NY
Zip	:	10023-7603
Country	:	US
Telephone Number	:	917-770-8727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	06/30/2015

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Directions to “ EKATERINA ZUBRITSKAYA PA, PH.D” Practice Location

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