Basic Information
| Provider Information | |||||||||
| NPI: | 1588820690 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALPHONSO L. SORHAINDO, PH.D. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | ALMAR PSYCHOLOGICAL SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1521 JARRET PL | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104612606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185181279 | ||||||||
| FaxNumber: | 7185181281 | ||||||||
| Practice Location | |||||||||
| Address1: | 1521 JARRET PL | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104612606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185181279 | ||||||||
| FaxNumber: | 7185181281 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2008 | ||||||||
| LastUpdateDate: | 07/29/2008 | ||||||||
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| AuthorizedOfficialLastName: | SORHAINDO | ||||||||
| AuthorizedOfficialFirstName: | ALPHONSO | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE PROPRIETOR | ||||||||
| AuthorizedOfficialTelephone: | 7185181279 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | PH,D, | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0855X | 004306-1 | NY | N | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | 261QM0850X | 004306-1 | NY | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 01234046 | 05 | NY | MEDICAID |