Provider Demographics
NPI:1386825065
Name:ALLURED, ELIZABETH MCKAY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MCKAY
Last Name:ALLURED
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 SOUTH SERVICE RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577
Mailing Address - Country:US
Mailing Address - Phone:516-484-5776
Mailing Address - Fax:
Practice Address - Street 1:220 SOUTH SERVICE RD
Practice Address - Street 2:SUITE 12
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577
Practice Address - Country:US
Practice Address - Phone:516-484-5776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0131872103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVL4761Medicare PIN