Provider Demographics
NPI:1104959618
Name:MANHATTAN PSYCHOLOGICAL ASSOCIATE, P.C.
Entity type:Organization
Organization Name:MANHATTAN PSYCHOLOGICAL ASSOCIATE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HACK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-307-9730
Mailing Address - Street 1:200 W 57TH ST STE 205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3211
Mailing Address - Country:US
Mailing Address - Phone:212-307-9730
Mailing Address - Fax:646-454-1479
Practice Address - Street 1:200 W 57TH ST STE 205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3211
Practice Address - Country:US
Practice Address - Phone:212-307-9730
Practice Address - Fax:646-454-1479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010345103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY118762OtherVALUE BEHAVIORAL HEALTH
NYP568731OtherOXFORD
NYV68961Medicare ID - Type UnspecifiedMEDICARE