Active NPI
Elyse R Dub, PH.D.
- Psychologist
- Short Hills, NJ
National Provider Identifier
1598928038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35S100491700
- Practice address
- 10 Woodcrest Ave
Short Hills, NJ 07078-2124 - Phone
- (917) 541-7340
- NPI assigned
- Jul 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 015620-1 | NY | |
| Psychologist | 103T00000X | 35S100491700 | NJ | Primary |
Addresses
Primary practice location
10 Woodcrest Ave
Short Hills, NJ 07078-2124
Mailing address
10 Woodcrest Ave
Short Hills, NJ 07078-2124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35S100491700 | NJ | MD | Psychologist |
| 015620-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615248000000",
"number": "1598928038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 WOODCREST AVE",
"city": "SHORT HILLS",
"state": "NJ",
"postal_code": "070782124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 WOODCREST AVE",
"city": "SHORT HILLS",
"state": "NJ",
"postal_code": "070782124",
"telephone_number": "917-541-7340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUB",
"first_name": "ELYSE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-03",
"last_updated": "2021-03-09",
"certification_date": "2021-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "015620-1",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35S100491700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Short Hills, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.