Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 024645 | NY |
Y | 103T00000X | Psychologist | 024645 | NY |
NPI | 1013675750 |
---|---|
Provider Name | Dr. Elissa Jacobs Habinsky |
First Address | Armonk, NY 10504-2326 |
Second Address | Mount Kisco, NY 10549-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |