Provider Demographics
NPI:1639109416
Name:WILLIAM ALANSON WHITE INSTITUTE OF PSYCHIATRY, PSYCHOANALYSIS & PSYCH
Entity Type:Organization
Organization Name:WILLIAM ALANSON WHITE INSTITUTE OF PSYCHIATRY, PSYCHOANALYSIS & PSYCH
Other - Org Name:WILLIAM ALANSON WHITE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:212-873-0725
Mailing Address - Street 1:20 W 74TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2401
Mailing Address - Country:US
Mailing Address - Phone:212-873-7070
Mailing Address - Fax:
Practice Address - Street 1:20 W 74TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2401
Practice Address - Country:US
Practice Address - Phone:212-873-7070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysisGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW09291Medicare ID - Type Unspecified