MEDICARE: AMBER TESTA PSY.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	103TC0700X	Clinical Psychologist	018918	NY

General Provider Information

NPI Number	:	1881987493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER TESTA PSY.D.

Provider Business Mailing Address
First Line	:	57 SHERWOOD FRST
Second Line	:	APT. B
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-5738
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3590 ROUTE 9
Second Line	:	SUITE 203
City	:	COLD SPRING
State	:	NY
Zip	:	10516-3876
Country	:	US
Telephone Number	:	856-875-7133
Fax Number	:

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

Provider Enumeration Date	:	05/16/2011
Last Update Date	:	05/16/2011

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