Provider Demographics
NPI:1548278054
Name:BLUMSTEIN, ALAN B (PHD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:B
Last Name:BLUMSTEIN
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 1:237 MAMARONECK AVE
Mailing Address - Street 2:4TH FLOOR, SUITE 400
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1319
Mailing Address - Country:US
Mailing Address - Phone:914-329-4998
Mailing Address - Fax:
Practice Address - Street 1:237 MAMARONECK AVE
Practice Address - Street 2:4TH FLOOR, SUITE 400
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1319
Practice Address - Country:US
Practice Address - Phone:914-329-4998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005850103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02377388Medicaid
6100508OtherEVERCARE
P00076690OtherMEDICARE RAILROAD
NY02377388Medicaid
P93846Medicare UPIN