Provider Demographics
NPI:1033969217
Name:RAYMAN, ELLIOT
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:
Last Name:RAYMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SAINT MARKS AVE APT 602
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-3991
Mailing Address - Country:US
Mailing Address - Phone:415-596-9324
Mailing Address - Fax:
Practice Address - Street 1:500 SAINT MARKS AVE APT 602
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-3991
Practice Address - Country:US
Practice Address - Phone:415-596-9324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist