Provider Demographics
NPI:1568679041
Name:DOCTORS, SHELLEY R (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:R
Last Name:DOCTORS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 RIVERSIDE DR
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6501
Mailing Address - Country:US
Mailing Address - Phone:212-873-3841
Mailing Address - Fax:212-787-3147
Practice Address - Street 1:52 RIVERSIDE DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-6501
Practice Address - Country:US
Practice Address - Phone:212-873-3841
Practice Address - Fax:212-787-3147
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006256103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis