Provider Demographics
NPI:1740539972
Name:ALBRIGHT, GLENN LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:LEE
Last Name:ALBRIGHT
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 1:58 MILLBROOK RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-1705
Mailing Address - Country:US
Mailing Address - Phone:914-234-2782
Mailing Address - Fax:
Practice Address - Street 1:55 LEXINGTON AVE
Practice Address - Street 2:DEPARTMENT OF PSYCHOLOGY B615
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5585
Practice Address - Country:US
Practice Address - Phone:646-312-3788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011442103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist