Provider Demographics
NPI:1225415383
Name:MICHAEL SCHWALBERG, PH.D., PSYCHOLOGIST, PLLC
Entity Type:Organization
Organization Name:MICHAEL SCHWALBERG, PH.D., PSYCHOLOGIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SCHWALBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-417-8809
Mailing Address - Street 1:345 N MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4305
Mailing Address - Country:US
Mailing Address - Phone:845-417-8809
Mailing Address - Fax:
Practice Address - Street 1:39 E 78TH ST
Practice Address - Street 2:SUITE 601
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0214
Practice Address - Country:US
Practice Address - Phone:845-417-8809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010814103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty