Provider Demographics
NPI:1003011552
Name:FINGERHUT, RANDY (PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:FINGERHUT
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 1:300 E LANCASTER AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-2139
Mailing Address - Country:US
Mailing Address - Phone:215-951-1284
Mailing Address - Fax:
Practice Address - Street 1:300 E LANCASTER AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-2139
Practice Address - Country:US
Practice Address - Phone:215-951-1284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-009165-L103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical