Provider Demographics
NPI:1508546565
Name:ELLINGTON, ALINA
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:
Last Name:ELLINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S HARMONY HILL RD
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-3142
Mailing Address - Country:US
Mailing Address - Phone:917-744-8080
Mailing Address - Fax:
Practice Address - Street 1:80 UNIVERSITY PL FL 2B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4564
Practice Address - Country:US
Practice Address - Phone:917-744-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001178102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty