Provider Demographics
NPI:1841477502
Name:MORRISON-DYKE, DEBRA F (PHD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:F
Last Name:MORRISON-DYKE
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 1:545 SAW MILL RIVER RD
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-2157
Mailing Address - Country:US
Mailing Address - Phone:914-329-0759
Mailing Address - Fax:914-478-5192
Practice Address - Street 1:545 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 3C
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-2157
Practice Address - Country:US
Practice Address - Phone:914-329-0759
Practice Address - Fax:914-478-5192
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2010-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0139331103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVE8731Medicare PIN