Provider Demographics
NPI:1356567853
Name:AMSEL, BEVERLY (PHD)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:
Last Name:AMSEL
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 1:165 W END AVE
Mailing Address - Street 2:#1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5503
Mailing Address - Country:US
Mailing Address - Phone:212-362-5903
Mailing Address - Fax:
Practice Address - Street 1:165 W END AVE
Practice Address - Street 2:#1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5503
Practice Address - Country:US
Practice Address - Phone:212-362-5903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000141-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst