Provider Demographics
NPI:1710156054
Name:LEYBOVICH, ETEL
Entity Type:Individual
Prefix:DR
First Name:ETEL
Middle Name:
Last Name:LEYBOVICH
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 1:101 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-3108
Mailing Address - Country:US
Mailing Address - Phone:914-432-5579
Mailing Address - Fax:
Practice Address - Street 1:101 MORNINGSIDE DR
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-3108
Practice Address - Country:US
Practice Address - Phone:914-432-5579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2470252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry