Provider Demographics
NPI:1033795422
Name:RAYMOND, RICHARD ROBB (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ROBB
Last Name:RAYMOND
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 1:49 5TH AVE # 1001
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2043
Mailing Address - Country:US
Mailing Address - Phone:718-650-3200
Mailing Address - Fax:
Practice Address - Street 1:49 5TH AVE # 1001
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2043
Practice Address - Country:US
Practice Address - Phone:718-650-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY2000033103TC0700X
VA0810007395103TC0700X
MD06526103TC0700X
NY024806103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical