Provider Demographics
NPI:1568851822
Name:SIPER, PAIGE MARIEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:MARIEL
Last Name:SIPER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PAIGE
Other - Middle Name:MARIEL
Other - Last Name:SIPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:150 E 61ST ST
Mailing Address - Street 2:APT 4F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8529
Mailing Address - Country:US
Mailing Address - Phone:305-510-3062
Mailing Address - Fax:
Practice Address - Street 1:ONE GUSTAVE LEVY PLACE
Practice Address - Street 2:BOX 1230
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02085103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical