Provider Demographics
NPI:1669698494
Name:GINSBURG, PAULETTE (MD)
Entity type:Individual
Prefix:
First Name:PAULETTE
Middle Name:
Last Name:GINSBURG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:90 WILLIAM ST APT 6G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-0103
Mailing Address - Country:US
Mailing Address - Phone:516-661-2011
Mailing Address - Fax:
Practice Address - Street 1:140 BROADWAY FL 46
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10005-1155
Practice Address - Country:US
Practice Address - Phone:917-277-9417
Practice Address - Fax:917-893-7790
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183945-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY120671Medicare ID - Type UnspecifiedGROUP PRACTICE