Provider Demographics
NPI:1013936145
Name:PAUSIC, BETH ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:PAUSIC
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 PARK AVE S
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7304
Mailing Address - Country:US
Mailing Address - Phone:212-677-8550
Mailing Address - Fax:
Practice Address - Street 1:257 PARK AVE S
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7304
Practice Address - Country:US
Practice Address - Phone:212-677-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015208-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02567884Medicaid
NYVM3181Medicare ID - Type UnspecifiedEMPIRE MEDICARE
NY02567884Medicaid