MEDICARE: DR. DIANE ALSON PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	007689-1	NY

General Provider Information

NPI Number	:	1407938749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE ALSON PH.D.

Provider Business Mailing Address
First Line	:	6 GLEN DR
Second Line	:
City	:	HARRISON
State	:	NY
Zip	:	10528-2406
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 MAMARONECK AVE
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-5202
Country	:	US
Telephone Number	:	914-835-2462
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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