Provider Demographics
NPI:1700909942
Name:ADLER, MANFRED (PHD)
Entity Type:Individual
Prefix:DR
First Name:MANFRED
Middle Name:
Last Name:ADLER
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 1:39790 ALSACE CT
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-6702
Mailing Address - Country:US
Mailing Address - Phone:216-382-9600
Mailing Address - Fax:
Practice Address - Street 1:5002 MAYFIELD ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-3136
Practice Address - Country:US
Practice Address - Phone:212-382-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH136103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist