Provider Demographics
NPI:1164634168
Name:EMERY, DEBRA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:
Last Name:EMERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CONSCIENCE MEADOW PATH
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2200
Mailing Address - Country:US
Mailing Address - Phone:631-751-0222
Mailing Address - Fax:
Practice Address - Street 1:4 CONSCIENCE MEADOW PATH
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2200
Practice Address - Country:US
Practice Address - Phone:631-751-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183149-12084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry