Doctor Name: | DR. ALAN NUDELMAN |
NPI Number: | 1013932235 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 008259 |
Business Practice Address: | 20 Squadron Blvd #470 New City, NY - 109565258 |
Business Phone Number: | 8456394630 |
Business Fax Number: | 8456394630 |
Mailing Address: | 20 Squadron Blvd, Suite 470 NEW CITY |
State: | NY |
Postal Code: | 109565200 |
Phone Number: | 8456394630 |
Fax Number: | 8456394630 |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 02/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 008259 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |