MEDICARE: ALBERG & ASSOCIATES, PA

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	103T00000X	Psychologist	LP0001	MN

General Provider Information

NPI Number	:	1952408171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALBERG & ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	4663 WHITE BEAR PKWY
Second Line	:
City	:	WHITE BEAR LAKE
State	:	MN
Zip	:	55110-3300
Country	:	US
Telephone Number	:	651-484-9554
Fax Number	:	651-484-0703

Provider Business Practice Location Address
First Line	:	4663 WHITE BEAR PKWY
Second Line	:
City	:	WHITE BEAR LAKE
State	:	MN
Zip	:	55110-3300
Country	:	US
Telephone Number	:	651-484-9554
Fax Number	:	651-484-0703

Authorized Official
Title or Position	:	OWNER
Name	:	DR. THOMAS LAWRENCE ALBERG
Credential	:	PHD
Telephone Number	:	651-484-9554

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/13/2013

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