Doctor Name: | DR. FREDERICK SCOTT KADUSHIN |
NPI Number: | 1104037670 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 5067 |
Business Practice Address: | 136 Dwight Rd Longmeadow, MA - 011061759 |
Business Phone Number: | 4135672008 |
Business Fax Number: | 4134510020 |
Mailing Address: | 84 Ellington St, LONGMEADOW |
State: | MA |
Postal Code: | 011061430 |
Phone Number: | 4135672008 |
Fax Number: | 4134510020 |
NPI Enumeration Date: | 05/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 5067 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |