Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 016205 | NY |
Y | 103T00000X | Psychologist | 016205 | NY |
NPI | 1013161116 |
---|---|
Provider Name | Dr. Ellen Verini |
First Address | Valhalla, NY 10595-1637 |
Second Address | Valhalla, NY 10595-1637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2008 |
Last Update Date | 17/11/2008 |