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General NPI Number Information
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NPI Number | 1861036675
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Entity Type | Individual
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Provider Name | ALLYSON HENTEL-KOPLIN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2019
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 189 W 89TH ST APT 5W
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City | NEW YORK
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State | NY
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Zip | 10024-1962
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Country | US
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Telephone | 917-817-5424
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Fax |
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Provider Business Mailing Address
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Address Line | 189 W 89TH ST APT 5W
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City | NEW YORK
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State | NY
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Zip | 10024-1962
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Country | US
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Telephone | 212-730-2099
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 015873
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License Number State | NY
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