Individual
MARK ALAN TATAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
726 COLUMBIA TPKE, EAST GREENBUSH, NY 12061-2215
(518) 674-0528
(518) 674-0528
Mailing address
9 CAYUGA CT, AVERILL PARK, NY 12018-9672
(518) 674-0528
(518) 674-0528
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009456
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01605710
—
NY
Enumeration date
05/20/2007
Last updated
07/08/2007
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