Provider Demographics
NPI:1699929943
Name:GELIEBTER, MINDY E
Entity type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:E
Last Name:GELIEBTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MINDY
Other - Middle Name:E
Other - Last Name:DOLNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 HASTINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1314
Mailing Address - Country:US
Mailing Address - Phone:845-362-7489
Mailing Address - Fax:845-362-7489
Practice Address - Street 1:10 HASTINGS RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1314
Practice Address - Country:US
Practice Address - Phone:845-362-7489
Practice Address - Fax:845-362-7489
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025716-11041C0700X
NY224041164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No164W00000XNursing Service ProvidersLicensed Practical Nurse