Provider Demographics
NPI:1598218075
Name:CANALSIDE PSYCHOLOGICAL HEALTH, PLLC
Entity Type:Organization
Organization Name:CANALSIDE PSYCHOLOGICAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONGI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:585-371-5020
Mailing Address - Street 1:170 OFFICE PARK WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1760
Mailing Address - Country:US
Mailing Address - Phone:585-371-5020
Mailing Address - Fax:
Practice Address - Street 1:170 OFFICE PARK WAY
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1760
Practice Address - Country:US
Practice Address - Phone:585-371-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021551103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty