Provider Demographics
NPI:1265462766
Name:ROSS, ALISON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W 56TH ST APT 5J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4316
Mailing Address - Country:US
Mailing Address - Phone:212-262-0224
Mailing Address - Fax:212-974-7563
Practice Address - Street 1:211 W 56TH ST APT 5J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4316
Practice Address - Country:US
Practice Address - Phone:212-262-0224
Practice Address - Fax:212-974-7563
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10074103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist