Provider Demographics
NPI:1831604743
Name:SHEYNKIN, ALLA (PSY D)
Entity type:Individual
Prefix:DR
First Name:ALLA
Middle Name:
Last Name:SHEYNKIN
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 BROADWAY
Mailing Address - Street 2:SUITE 204, SELF WORKS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:347-291-1106
Mailing Address - Fax:212-213-4238
Practice Address - Street 1:150 EAST 58TH ST
Practice Address - Street 2:21ST FLOOR, SELF WORKS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10155
Practice Address - Country:US
Practice Address - Phone:347-291-1104
Practice Address - Fax:212-213-4238
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022460103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent