Provider Demographics
NPI:1407009004
Name:LEDERMAN, ALISON LYN
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:LYN
Last Name:LEDERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALISON
Other - Middle Name:LYN
Other - Last Name:LEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS SCIENCE
Mailing Address - Street 1:81 HAVERMILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3138
Mailing Address - Country:US
Mailing Address - Phone:845-634-2835
Mailing Address - Fax:
Practice Address - Street 1:81 HAVERMILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3138
Practice Address - Country:US
Practice Address - Phone:845-634-2835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YOOOOOX101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor