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General NPI Number Information
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NPI Number | 1205101011
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Entity Type | Organization
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Legal Business Name | ALISA KRIEGEL PHD PC
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 270 LAFAYETTE ST STE. 500
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City | NEW YORK
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State | NY
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Zip | 10012-3311
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Country | US
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Telephone | 646-553-5490
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Fax | 646-553-5493
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Provider Business Mailing Address
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Address Line | 270 LAFAYETTE ST STE. 500
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City | NEW YORK
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State | NY
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Zip | 10012-3311
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Country | US
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Telephone | 646-553-5490
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Fax | 646-553-5493
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Authorized Official
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Title or Position | OWNER
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Name | ALISA R KRIEGEL
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Credential | PHD
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Telephone | 646-553-5490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 019061
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License Number State | NY
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