MEDICARE: ARCHER PSYCHOLOGICAL ASSOCIATES, PLLC

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	012634	NY

General Provider Information

NPI Number	:	1851897185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCHER PSYCHOLOGICAL ASSOCIATES, PLLC

Provider Business Mailing Address
First Line	:	9 ARCHER PL
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-4101
Country	:	US
Telephone Number	:	914-772-2709
Fax Number	:

Provider Business Practice Location Address
First Line	:	547 SAW MILL RIVER RD STE 3G
Second Line	:
City	:	ARDSLEY
State	:	NY
Zip	:	10502-2154
Country	:	US
Telephone Number	:	914-772-2709
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST/PARTNER
Name	:	DR. MANUEL ALUMA
Credential	:	PH.D.
Telephone Number	:	914-772-2709

Provider Enumeration Date	:	04/04/2018
Last Update Date	:	04/04/2018

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