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Provider Information for 1013936145


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Dr. BETH ANN PAUSIC Psy.D


Sex: Female

NPI: 1013936145
Last Updated: 2008-10-16
Certification Date:

Details

NameValue
NPI1013936145
Enumeration Date2006-07-19
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 257 PARK AVE S
3RD FLOOR
NEW YORK, NY 10010-7304
United States

Phone: 212-677-8550 | Fax:
 
Primary Practice Address 257 PARK AVE S
3RD FLOOR
NEW YORK, NY 10010-7304
United States

Phone: 212-677-8550 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNY02567884
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 103TC0700X - Psychologist - ClinicalNY015208-1