Provider Demographics
NPI:1912024365
Name:EDYTHE ADLER, PSY.D.
Entity Type:Organization
Organization Name:EDYTHE ADLER, PSY.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDYTHE
Authorized Official - Middle Name:BRENDA
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:914-725-8121
Mailing Address - Street 1:195 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1820
Mailing Address - Country:US
Mailing Address - Phone:914-725-8121
Mailing Address - Fax:914-725-8121
Practice Address - Street 1:2500 JOHNSON AVE
Practice Address - Street 2:SUITE 1M
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4925
Practice Address - Country:US
Practice Address - Phone:718-796-1101
Practice Address - Fax:914-725-8121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYSO-9976-2OtherWORKERS COMPENSATION
NY6800164OtherGHI-BMP
NY051127OtherVALUE OPTIONS