Individual
ILEEN LISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
17 BARSTOW RD, SUITE 400, GREAT NECK, NY 11021-2213
(516) 829-2941
Mailing address
17 BARSTOW RD, SUITE 400, GREAT NECK, NY 11021-2213
(516) 829-2941
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
010905-1
NY
103TC0700X
Clinical Psychologist
Primary
010905-1
NY
Other
Enumeration date
07/02/2007
Last updated
09/11/2025
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