| Alliance Psychological Services Of New York, Pllc | |
|
6014 67th Ave # 1 Ridgewood NY 11385-4536 | |
| (718) 971-9731 | |
| (718) 425-9862 |
| Full Name | Alliance Psychological Services Of New York, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 6014 67th Ave # 1, Ridgewood, New York |
| Authorized Official Name and Position | William Somerville (OWNER) |
| Authorized Official Contact | 7189719731 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Psychological Services Of New York, Pllc 6014 67th Ave # 1 Ridgewood NY 11385-4536 Ph: (718) 971-9731 | Alliance Psychological Services Of New York, Pllc 6014 67th Ave # 1 Ridgewood NY 11385-4536 Ph: (718) 971-9731 |
| NPI Number | 1508374646 |
|---|---|
| Provider Enumeration Date | 01/10/2018 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Medicare PECOS PAC ID | 1658632575 |
|---|---|
| Medicare Enrollment ID | O20180309000822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508374646 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 022436 (New York) | Primary |
| Provider Name | William Somerville |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891181368 PECOS PAC ID: 2567723489 Enrollment ID: I20180312000023 |
| Provider Name | Dawn Mcmillian Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447804026 PECOS PAC ID: 6709292519 Enrollment ID: I20210302002748 |
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