MEDICARE: CAROL A. ALBERT PSYCHOLOGIST, P.C.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1083878201	OTHER	NY	NPPES

General Provider Information

NPI Number	:	1235427659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROL A. ALBERT PSYCHOLOGIST, P.C.

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	:

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	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CAROL ALBERT
Credential	:	PH.D.
Telephone Number	:	212-721-5757

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	07/19/2011

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