Provider Demographics
NPI:1184821233
Name:AUERBACH, WILLIAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:AUERBACH
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 1:433 W 21ST ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2908
Mailing Address - Country:US
Mailing Address - Phone:212-675-4118
Mailing Address - Fax:
Practice Address - Street 1:425 W 23RD ST RM 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1436
Practice Address - Country:US
Practice Address - Phone:212-675-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009492-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV55011Medicare ID - Type UnspecifiedMEDCARE PROVIDER NUMBER