Basic Information
| Provider Information | |||||||||
| NPI: | 1124385984 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIEDLER | ||||||||
| FirstName: | INA | ||||||||
| MiddleName: | LESLEY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PSY.D., YESHIVA UNIV | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STERNBERG | ||||||||
| OtherFirstName: | INA | ||||||||
| OtherMiddleName: | LESLEY | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | PSY.D. (DOCTOR OF PS | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 30 MANHATTAN AVENUE | ||||||||
| Address2: | LOIS BRONZ CHILDREN'S CENTER | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147616134 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 30 MANHATTAN AVENUE | ||||||||
| Address2: | LOIS BRONZ CHILDREN'S CENTER | ||||||||
| City: | WHITE PLAINS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147616134 | ||||||||
| FaxNumber: | 9147615461 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2012 | ||||||||
| LastUpdateDate: | 04/18/2012 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TS0200X | NYS#011954 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | School |
No ID Information.