Provider Demographics
NPI:1356663777
Name:ORBER, LINDA JOY (MA, NCPSYA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JOY
Last Name:ORBER
Suffix:
Gender:F
Credentials:MA, NCPSYA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1622
Mailing Address - Country:US
Mailing Address - Phone:718-720-0632
Mailing Address - Fax:
Practice Address - Street 1:452 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-1622
Practice Address - Country:US
Practice Address - Phone:718-720-0632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000267102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000267OtherLICENSE PSYCHOANALYST NYS 000267