Provider Demographics
NPI:1447328000
Name:MOLTENI, ANDREW L (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:L
Last Name:MOLTENI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:63 FRANKLIN STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-3065
Mailing Address - Country:US
Mailing Address - Phone:518-587-0499
Mailing Address - Fax:518-587-0536
Practice Address - Street 1:63 FRANKLIN STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-3065
Practice Address - Country:US
Practice Address - Phone:518-587-0499
Practice Address - Fax:518-587-0536
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2019-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY8987-1103G00000X, 103T00000X, 103TA0700X, 103TF0000X, 103TH0100X, 103TR0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01008337Medicaid
NY51018BMedicare PIN