1912024365 NPI number — EDYTHE ADLER, PSY.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912024365 NPI number — EDYTHE ADLER, PSY.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EDYTHE ADLER, PSY.D.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912024365
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
195 LONGVIEW DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCARSDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10583-1820
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-725-8121
Provider Business Mailing Address Fax Number:
914-725-8121

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 JOHNSON AVE
Provider Second Line Business Practice Location Address:
SUITE 1M
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10463-4925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-796-1101
Provider Business Practice Location Address Fax Number:
914-725-8121
Provider Enumeration Date:
03/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ADLER
Authorized Official First Name:
EDYTHE
Authorized Official Middle Name:
BRENDA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
914-725-8121

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SO-9976-2 . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6800164 . This is a "GHI-BMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 051127 . This is a "VALUE OPTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com