Provider Demographics
NPI:1104905603
Name:HALL, ELAINE C (PHD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:C
Last Name:HALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8856
Mailing Address - Country:US
Mailing Address - Phone:212-674-0084
Mailing Address - Fax:212-792-6058
Practice Address - Street 1:50 W 23RD ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5205
Practice Address - Country:US
Practice Address - Phone:212-674-0084
Practice Address - Fax:212-792-6058
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017983103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist