Provider Demographics
NPI:1447317086
Name:ALTER, STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:ALTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11045 QUEENS BLVD
Mailing Address - Street 2:SUITE A2
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5501
Mailing Address - Country:US
Mailing Address - Phone:718-575-3356
Mailing Address - Fax:718-261-3210
Practice Address - Street 1:11045 QUEENS BLVD
Practice Address - Street 2:SUITE A2
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5501
Practice Address - Country:US
Practice Address - Phone:718-575-3356
Practice Address - Fax:718-261-3210
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010152-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00442Medicare ID - Type Unspecified