MEDICARE: DR. LORI ALLISON SPECHLER-SIDMAN M.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	2084P0800X	Psychiatry Physician	228592	NY

General Provider Information

NPI Number	:	1750461554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI ALLISON SPECHLER-SIDMAN M.D.

Provider Business Mailing Address
First Line	:	50 E 78TH ST
Second Line	:	SUITE 9D
City	:	NEW YORK
State	:	NY
Zip	:	10075
Country	:	US
Telephone Number	:	212-794-0979
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 E 78TH ST
Second Line	:	SUITE 9D
City	:	NEW YORK
State	:	NY
Zip	:	10021-1837
Country	:	US
Telephone Number	:	212-794-0979
Fax Number	:

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

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