MEDICARE: DR. LILIANA MONICA RUSANSKY DROB PSY.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	15764	NY

General Provider Information

NPI Number	:	1851382949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LILIANA MONICA RUSANSKY DROB PSY.D.

Provider Business Mailing Address
First Line	:	8 CAMBRIDGE PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11238-1908
Country	:	US
Telephone Number	:	718-783-0141
Fax Number	:	718-732-0043

Provider Business Practice Location Address
First Line	:	26 COURT ST
Second Line	:	SUITE 1214
City	:	BROOKLYN
State	:	NY
Zip	:	11242-0103
Country	:	US
Telephone Number	:	646-262-7834
Fax Number	:	718-732-0043

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

Provider Enumeration Date	:	10/29/2005
Last Update Date	:	07/08/2007

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