Provider Demographics
NPI:1740997311
Name:FUNK, ALLISON PATRICIA (PHD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:PATRICIA
Last Name:FUNK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E. 58TH ST
Mailing Address - Street 2:FIFTH FLOOR ANNEX
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10155
Mailing Address - Country:US
Mailing Address - Phone:212-308-2440
Mailing Address - Fax:
Practice Address - Street 1:150 E. 58TH ST
Practice Address - Street 2:FIFTH FLOOR ANNEX
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10155
Practice Address - Country:US
Practice Address - Phone:212-308-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical