Individual
DR. RICHARD MARK KAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1 PINNACLE PL, SUITE 200, ALBANY, NY 12203-3496
(518) 426-2600
Mailing address
60 ACADEMY RD, ALBANY, NY 12208-3103
(518) 426-2600
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
005659
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11578466
CAQH PROVIDER ID
NY
Enumeration date
12/25/2006
Last updated
07/08/2007
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