Provider Demographics
NPI:1750496626
Name:FERLEGER, NAOMI ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:ANNE
Last Name:FERLEGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 PLOCHMANN LN
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-1616
Mailing Address - Country:US
Mailing Address - Phone:845-679-5036
Mailing Address - Fax:
Practice Address - Street 1:9 MANSION ST
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2309
Practice Address - Country:US
Practice Address - Phone:845-486-3700
Practice Address - Fax:845-486-3727
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012361-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV0111Medicare ID - Type UnspecifiedPROVIDER NUMBER