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General NPI Number Information
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NPI Number | 1396451365
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Entity Type | Individual
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Provider Name | GINA D ALAGO-COLON
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Gender | Female
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 120 E WASHINGTON ST STE 721
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City | SYRACUSE
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State | NY
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Zip | 13202-4096
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Country | US
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Telephone | 315-426-3996
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Fax |
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Provider Business Mailing Address
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Address Line | 689 N CLINTON ST APT 329
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City | SYRACUSE
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State | NY
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Zip | 13204-1479
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Country | US
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Telephone | 787-226-5810
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 025370
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License Number State | NY
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