Healthcare Provider Details

I. General information

NPI: 1205291747
Provider Name (Legal Business Name): MEDICAL ALLIANCE OF NEW YORK PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 ROBERT PITT DR UNIT 209
MONSEY NY
10952-3330
US

IV. Provider business mailing address

PO BOX 1250
MONSEY NY
10952-8349
US

V. Phone/Fax

Practice location:
  • Phone: 718-506-1115
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: NATHAN ZEMEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-298-4375