Healthcare Provider Details

I. General information

NPI: 1245512433
Provider Name (Legal Business Name): ADRIENNE W. KATZOW PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 N BROADWAY STE 206
IRVINGTON NY
10533-3203
US

IV. Provider business mailing address

90 N BROADWAY
IRVINGTON NY
10533-3200
US

V. Phone/Fax

Practice location:
  • Phone: 347-708-6580
  • Fax:
Mailing address:
  • Phone: 347-708-6580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number019189-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: