Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TS0200X | School Psychologist |
NPI | 1114165792 |
---|---|
Provider Name | Mr. Alexander Mondrow |
First Address | Bronx, NY 10461-2105 |
Second Address | Monsey, NY 10952-3365 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2009 |
Last Update Date | 04/02/2009 |