| Doctor Name: | MS. ELISSA DUA |
| NPI Number: | 1073826376 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | 1125761 |
| Business Practice Address: | 6725 188th St Fresh Meadows, NY - 113653767 |
| Business Phone Number: | 7184546460 |
| Business Fax Number: | |
| Mailing Address: | 14751 28th Ave, FLUSHING |
| State: | NY |
| Postal Code: | 113541436 |
| Phone Number: | 7184546460 |
| Fax Number: | |
| NPI Enumeration Date: | 07/15/2010 |
| NPI Last Update Date: | 07/15/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | 1125761 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |