Individual
ALICE A MEDALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
MMC - DEPT. OF PSYCHIATRY, 111 EAST 210TH STREET, KLAU 2, BRONX, NY 10467
(718) 920-7311
Mailing address
6 CLUBWAY, HARTSDALE, NY 10530-3615
(718) 920-7311
(718) 405-0401
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
007362
NY
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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