Provider Demographics
NPI:1255547790
Name:MCALLISTER, EDWARD W (PHD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:W
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ADAMS PL
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-3235
Mailing Address - Country:US
Mailing Address - Phone:518-439-9113
Mailing Address - Fax:
Practice Address - Street 1:45 FERRY ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-4115
Practice Address - Country:US
Practice Address - Phone:518-244-2070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4071103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist