Provider Demographics
NPI:1871693242
Name:MOHL, ALLAN SUSSMAN (MSS PHD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:SUSSMAN
Last Name:MOHL
Suffix:
Gender:M
Credentials:MSS PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:APT 40
Mailing Address - City:SCARBOROUGH
Mailing Address - State:NY
Mailing Address - Zip Code:10510
Mailing Address - Country:US
Mailing Address - Phone:914-923-1060
Mailing Address - Fax:
Practice Address - Street 1:369 ASHFORD AVENUE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-9207
Practice Address - Country:US
Practice Address - Phone:914-282-6583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYROO23341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical