Healthcare Provider Details

I. General information

NPI: 1598750002
Provider Name (Legal Business Name): ARLENE KAGLE LERNER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ARLENE KAGLE PH.D.

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

639 WEST END AVE
NEW YORK NY
10025
US

IV. Provider business mailing address

156 OHLAND RD
STANFORDVILLE NY
12581-5604
US

V. Phone/Fax

Practice location:
  • Phone: 212-724-6394
  • Fax:
Mailing address:
  • Phone: 845-868-7005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number05363
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: