Provider Demographics
NPI:1750461554
Name:SPECHLER-SIDMAN, LORI ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:ALLISON
Last Name:SPECHLER-SIDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E 78TH ST
Mailing Address - Street 2:SUITE 9D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075
Mailing Address - Country:US
Mailing Address - Phone:212-794-0979
Mailing Address - Fax:
Practice Address - Street 1:50 E 78TH ST
Practice Address - Street 2:SUITE 9D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-1837
Practice Address - Country:US
Practice Address - Phone:212-794-0979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2285922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry