MEDICARE: DR. ANDREW L. MOLTENI PH.D.

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	103G00000X	Clinical Neuropsychologist	8987-1	NY
2	103T00000X	Psychologist	8987-1	NY
3	103TA0700X	Adult Development & Aging Psychologist	8987-1	NY
4	103TF0000X	Family Psychologist	8987-1	NY
5	103TH0100X	Health Service Psychologist	8987-1	NY
6	103TR0400X	Rehabilitation Psychologist	8987-1	NY
7	103TC0700X	Clinical Psychologist	8987-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447328000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW L. MOLTENI PH.D.

Provider Business Mailing Address
First Line	:	63 FRANKLIN STREET
Second Line	:	SUITE 1
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-3065
Country	:	US
Telephone Number	:	518-587-0499
Fax Number	:	518-587-0536

Provider Business Practice Location Address
First Line	:	63 FRANKLIN STREET
Second Line	:	SUITE 1
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-3065
Country	:	US
Telephone Number	:	518-587-0499
Fax Number	:	518-587-0536

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	02/13/2019

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