Provider Demographics
NPI:1508048810
Name:ZUBRITSKAYA, EKATERINA (PA, PHD)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:ZUBRITSKAYA
Suffix:
Gender:F
Credentials:PA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 E 14TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2946
Mailing Address - Country:US
Mailing Address - Phone:917-770-8727
Mailing Address - Fax:
Practice Address - Street 1:1841 BROADWAY FL 4
Practice Address - Street 2:5 WEST 86TH STREET, SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7603
Practice Address - Country:US
Practice Address - Phone:917-770-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17511101YA0400X
NY000942-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000941-1OtherTHE UNIVERSITY OF THE STATE OF NEW YORK, PSYCHOANALYST LICENSE
NY8978881OtherREGISTRATION CERTIFICATE FOR THE LICENSE OF PSYCHOANALIST