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General NPI Number Information
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NPI Number | 1225415383
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Entity Type | Organization
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Legal Business Name | MICHAEL SCHWALBERG, PH.D., PSYCHOLOGIST, PLLC
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 39 E 78TH ST SUITE 601
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City | NEW YORK
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State | NY
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Zip | 10075-0214
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Country | US
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Telephone | 845-417-8809
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Fax |
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Provider Business Mailing Address
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Address Line | 345 N MAIN ST SUITE 1
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City | NEW CITY
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State | NY
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Zip | 10956-4305
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Country | US
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Telephone | 845-417-8809
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. MICHAEL DAVID SCHWALBERG
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Credential | PH.D.
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Telephone | 845-417-8809
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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 | 010814
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License Number State | NY
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