Provider Demographics
NPI:1033237508
Name:ADLER, ELLIOT MATHEW (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:MATHEW
Last Name:ADLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 E 37TH ST
Mailing Address - Street 2:1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3063
Mailing Address - Country:US
Mailing Address - Phone:212-689-2927
Mailing Address - Fax:914-725-0051
Practice Address - Street 1:117 E 37TH ST
Practice Address - Street 2:1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3063
Practice Address - Country:US
Practice Address - Phone:212-689-2927
Practice Address - Fax:914-725-0051
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004333-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical