Provider Demographics
NPI:1518468529
Name:ALEXANDRA BOSCO LUGER, PSY.D., P.C.
Entity Type:Organization
Organization Name:ALEXANDRA BOSCO LUGER, PSY.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:BOSCO
Authorized Official - Last Name:LUGER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-399-0609
Mailing Address - Street 1:276 1ST AVE APT 12G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1860
Mailing Address - Country:US
Mailing Address - Phone:312-399-0609
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E STE 1104
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3226
Practice Address - Country:US
Practice Address - Phone:646-586-2236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-25
Last Update Date:2018-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021717103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty