Provider Demographics
NPI:1427374909
Name:NEUNZIG, KARA ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KARA
Middle Name:ELIZABETH
Last Name:NEUNZIG
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 1:1620 ROUTE 22
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4051
Mailing Address - Country:US
Mailing Address - Phone:845-278-2500
Mailing Address - Fax:845-278-0781
Practice Address - Street 1:1620 ROUTE 22
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:06784
Practice Address - Country:US
Practice Address - Phone:845-278-2500
Practice Address - Fax:845-278-2500
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014213-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00769457Medicaid