Individual
MARCIA ELLIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
228 E BROADWAY, NEW YORK, NY 10002-5601
(212) 475-7755
(212) 475-5035
Mailing address
1 OLD COUNTRY RD, SUITE 271, CARLE PLACE, NY 11514-1801
(800) 725-6280
(800) 725-6380
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0101851
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01556885
—
NY
Enumeration date
06/22/2006
Last updated
11/19/2007
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