Provider Demographics
NPI:1922109099
Name:MORSE, ELSA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELSA
Middle Name:
Last Name:MORSE
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 1:1625 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3505
Mailing Address - Country:US
Mailing Address - Phone:347-247-9800
Mailing Address - Fax:718-273-4075
Practice Address - Street 1:1625 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3505
Practice Address - Country:US
Practice Address - Phone:347-247-9800
Practice Address - Fax:718-273-4075
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015807103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY103T00000XOtherPSYCHOLOGIST