Individual
DR. CARMEN E. ELIZONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-PSY.D
Contact information
Practice address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Mailing address
155 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4028
(845) 703-6999
(845) 703-6297
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
RO29929-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020227847
—
NY
Enumeration date
12/28/2006
Last updated
04/04/2016
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