MEDICARE: DR. DEBRA F MORRISON-DYKE 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	103TC0700X	Clinical Psychologist	0139331	NY

General Provider Information

NPI Number	:	1841477502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA F MORRISON-DYKE PH.D

Provider Business Mailing Address
First Line	:	545 SAW MILL RIVER RD
Second Line	:	SUITE 3C
City	:	ARDSLEY
State	:	NY
Zip	:	10502-2157
Country	:	US
Telephone Number	:	914-329-0759
Fax Number	:	914-478-5192

Provider Business Practice Location Address
First Line	:	545 SAW MILL RIVER RD
Second Line	:	SUITE 3C
City	:	ARDSLEY
State	:	NY
Zip	:	10502-2157
Country	:	US
Telephone Number	:	914-329-0759
Fax Number	:	914-478-5192

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

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	09/26/2010

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