Provider Demographics
NPI:1164973525
Name:AZUS, ALLISON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:AZUS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MRS
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:BERNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2801 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-2326
Mailing Address - Country:US
Mailing Address - Phone:516-992-3118
Mailing Address - Fax:
Practice Address - Street 1:2801 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-2326
Practice Address - Country:US
Practice Address - Phone:516-992-3118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020166103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical