Provider Demographics
NPI:1811034952
Name:SEGAL, ALISON BUCHALTER (PHD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:BUCHALTER
Last Name:SEGAL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ALISON
Other - Middle Name:JEANNE
Other - Last Name:BUCHALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 MAIN ST
Mailing Address - Street 2:STE 1000
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1900
Mailing Address - Country:US
Mailing Address - Phone:212-692-9288
Mailing Address - Fax:
Practice Address - Street 1:104 E 40TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1801
Practice Address - Country:US
Practice Address - Phone:212-692-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2016-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016192103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVM6911Medicare ID - Type UnspecifiedPSYCHOLOGIST