Provider Demographics
NPI:1811415052
Name:ADLER, MICHAEL S
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:ADLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 ROBERT PITT DR STE 101B
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3366
Mailing Address - Country:US
Mailing Address - Phone:845-425-5252
Mailing Address - Fax:
Practice Address - Street 1:25 ROBERT PITT DR STE 101B
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3366
Practice Address - Country:US
Practice Address - Phone:845-425-5252
Practice Address - Fax:845-425-5252
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022334103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist