Provider Demographics
NPI:1699898411
Name:SITRIN, ALLISON GAYLE (PHD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:GAYLE
Last Name:SITRIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W 25TH ST
Mailing Address - Street 2:SUITE 802
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7405
Mailing Address - Country:US
Mailing Address - Phone:917-743-8204
Mailing Address - Fax:
Practice Address - Street 1:138 W 25TH ST
Practice Address - Street 2:SUITE 802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7405
Practice Address - Country:US
Practice Address - Phone:917-743-8204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015896103TC2200X, 103T00000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool