Provider Demographics
NPI:1861844581
Name:ELLIOTT, ANNE REBECCA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:REBECCA
Last Name:ELLIOTT
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 1:38 GRAMERCY PARK N
Mailing Address - Street 2:STE. 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7458
Mailing Address - Country:US
Mailing Address - Phone:914-275-8323
Mailing Address - Fax:
Practice Address - Street 1:38 GRAMERCY PARK N
Practice Address - Street 2:STE. 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7458
Practice Address - Country:US
Practice Address - Phone:914-275-8323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000866103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist