| Academic Health Psychology Associates, P.c. | |
|
462 Grider St Room G208 Buffalo NY 14215-3021 | |
| (716) 898-5671 | |
| (716) 898-3040 |
| Full Name | Academic Health Psychology Associates, P.c. |
|---|---|
| Speciality | Psychologist - Cognitive & Behavioral |
| Location | 462 Grider St, Buffalo, New York |
| Authorized Official Name and Position | Jeffrey Mark Lackner (OWNER) |
| Authorized Official Contact | 7168985671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Academic Health Psychology Associates, P.c. Po Box 93 Amherst NY 14226-0093 Ph: (716) 898-5671 | Academic Health Psychology Associates, P.c. 462 Grider St Room G208 Buffalo NY 14215-3021 Ph: (716) 898-5671 |
| NPI Number | 1013049279 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013049279 | NPI | - | NPPES |
| 000523299002 | Other | NY | BLUE CROSS ID NUMBER |
| DF1724 | Other | NY | RR MEDICARE |
| 00025302101 | Other | NY | UNIVERA ID NUMBER |
| 6108856 | Other | NY | IHA ID NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | 012051-1 (New York) | Primary |
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