Provider Demographics
NPI:1205101011
Name:ALISA KRIEGEL PHD PC
Entity type:Organization
Organization Name:ALISA KRIEGEL PHD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:646-553-5490
Mailing Address - Street 1:270 LAFAYETTE ST
Mailing Address - Street 2:STE. 500
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3311
Mailing Address - Country:US
Mailing Address - Phone:646-553-5490
Mailing Address - Fax:646-553-5493
Practice Address - Street 1:270 LAFAYETTE ST
Practice Address - Street 2:STE. 500
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3311
Practice Address - Country:US
Practice Address - Phone:646-553-5490
Practice Address - Fax:646-553-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019061103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty