Provider Demographics
NPI:1871657015
Name:TSUI, ELLEN C (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:C
Last Name:TSUI
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 1:128 MOTT ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-5540
Mailing Address - Country:US
Mailing Address - Phone:718-694-0938
Mailing Address - Fax:718-694-0938
Practice Address - Street 1:128 MOTT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5540
Practice Address - Country:US
Practice Address - Phone:718-694-0938
Practice Address - Fax:718-694-0938
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011205103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY651287895OtherEMPLOYER IDENTIFICATION #