Provider Demographics
NPI:1982723193
Name:AURICCHIO, ELIZABETH WILLIAMS (PHD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WILLIAMS
Last Name:AURICCHIO
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 1:540 E 20TH ST
Mailing Address - Street 2:3-F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1330
Mailing Address - Country:US
Mailing Address - Phone:212-228-9350
Mailing Address - Fax:212-460-8648
Practice Address - Street 1:540 E 20TH ST
Practice Address - Street 2:3-F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-1330
Practice Address - Country:US
Practice Address - Phone:212-228-9350
Practice Address - Fax:212-460-8648
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3957103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV08611Medicare UPIN