Provider Demographics
NPI:1841498805
Name:DELESSIO-NEUBAUER, ELIZABETH (PSYD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:DELESSIO-NEUBAUER
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 1:1081 MAIN ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-3504
Mailing Address - Country:US
Mailing Address - Phone:845-857-5354
Mailing Address - Fax:
Practice Address - Street 1:1081 MAIN ST
Practice Address - Street 2:SUITE F
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-3504
Practice Address - Country:US
Practice Address - Phone:845-857-5354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011495103T00000X, 251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No251300000XAgenciesLocal Education Agency (LEA)