Individual
DR. BARUCH ELITZUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
32 CHURCH ST, ROSLYN, NY 11576-1131
(631) 547-9191
Mailing address
32 CHURCH ST, ROSLYN, NY 11576-1131
(631) 547-9191
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
004676-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
468882
VALUE OPTIONS
NY
01
—
EB865200
GHI
NY
Enumeration date
07/23/2006
Last updated
12/02/2016
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