Provider Demographics
NPI:1609155506
Name:ELKOUBI, ALLISON L (PHD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:L
Last Name:ELKOUBI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:L
Other - Last Name:LEBOWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3374 5TH ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-5118
Mailing Address - Country:US
Mailing Address - Phone:516-246-5414
Mailing Address - Fax:
Practice Address - Street 1:3374 5TH ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-5118
Practice Address - Country:US
Practice Address - Phone:516-246-5414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019194103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical