Provider Demographics
NPI:1548331820
Name:MAHER, ALICE LOMBARDO (MD)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:LOMBARDO
Last Name:MAHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 CENTRAL PARK W
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6547
Mailing Address - Country:US
Mailing Address - Phone:212-866-1883
Mailing Address - Fax:212-662-5098
Practice Address - Street 1:350 CENTRAL PARK W
Practice Address - Street 2:SUITE 1G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6547
Practice Address - Country:US
Practice Address - Phone:212-866-1883
Practice Address - Fax:212-662-5098
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1296172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY144903OtherVALUEOPTIONS
NYGHIOther0011007
NY00275067Medicaid
NYGHIOther0011007