MEDICARE: DR. CAROL A ALBERT PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0085151	NY

General Provider Information

NPI Number	:	1083878201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL A ALBERT PHD

Provider Business Mailing Address
First Line	:	122 W 71ST ST
Second Line	:	APT. 4
City	:	NEW YORK
State	:	NY
Zip	:	10023-4036
Country	:	US
Telephone Number	:	212-721-5757
Fax Number	:	212-721-1910

Provider Business Practice Location Address
First Line	:	122 W 71ST ST
Second Line	:	APT. 4
City	:	NEW YORK
State	:	NY
Zip	:	10023-4036
Country	:	US
Telephone Number	:	212-721-5757
Fax Number	:	212-721-1910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2008
Last Update Date	:	07/16/2008

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