Basic Information
Provider Information
NPI: 1033364302
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RISHER
FirstName: ELISE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PH., D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 34 S BROADWAY
Address2: SUITE #600
City: WHITE PLAINS
State: NY
PostalCode: 106014400
CountryCode: US
TelephoneNumber: 9146819435
FaxNumber:  
Practice Location
Address1: 34 S BROADWAY
Address2: SUITE #600
City: WHITE PLAINS
State: NY
PostalCode: 106014400
CountryCode: US
TelephoneNumber: 9146819435
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/29/2008
LastUpdateDate: 11/29/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X01682301NYY Behavioral Health & Social Service ProvidersPsychologistClinical

ID Information
IDTypeStateIssuerDescription
0168230101NYNYS LICENSEOTHER


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