Provider Demographics
NPI:1073796363
Name:ADIRONDACK NEUROPSYCHOLOGICAL ASSOCIATES
Entity Type:Organization
Organization Name:ADIRONDACK NEUROPSYCHOLOGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON-HANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:518-581-7260
Mailing Address - Street 1:1 WEST AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6064
Mailing Address - Country:US
Mailing Address - Phone:518-581-7260
Mailing Address - Fax:518-581-7260
Practice Address - Street 1:1 WEST AVE STE 205
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6064
Practice Address - Country:US
Practice Address - Phone:518-581-7260
Practice Address - Fax:518-581-7260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013031103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02058015Medicaid
NYAA0605Medicare PIN