Provider Demographics
NPI:1548483969
Name:VORUS, E. NEAL (PHD)
Entity type:Individual
Prefix:DR
First Name:E.
Middle Name:NEAL
Last Name:VORUS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:ELWIN
Other - Middle Name:NEAL
Other - Last Name:VORUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:498 W END AVE
Mailing Address - Street 2:#1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4314
Mailing Address - Country:US
Mailing Address - Phone:212-362-9272
Mailing Address - Fax:
Practice Address - Street 1:498 W END AVE
Practice Address - Street 2:#1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4314
Practice Address - Country:US
Practice Address - Phone:212-362-9272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013733103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY194217OtherMANAGED HEALTH NETWORK
NY02692813Medicaid
NY01373368OtherHIP
NYP1539746OtherOXFORD