Provider Demographics
NPI:1558391318
Name:ADLER, SUSAN S (PSYD,ABSNP)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:S
Last Name:ADLER
Suffix:
Gender:F
Credentials:PSYD,ABSNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 GREENE LN
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5111
Mailing Address - Country:US
Mailing Address - Phone:914-682-7575
Mailing Address - Fax:914-682-7595
Practice Address - Street 1:14 RYE RIDGE PLZ
Practice Address - Street 2:SUITE 236
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2826
Practice Address - Country:US
Practice Address - Phone:914-253-4927
Practice Address - Fax:914-682-7595
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009092103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist