Provider Demographics
NPI:1063683290
Name:RIFKIN, ANTHONY J (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:J
Last Name:RIFKIN
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 1:575 MADISON AVE
Mailing Address - Street 2:SUITE 1006
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2511
Mailing Address - Country:US
Mailing Address - Phone:212-605-0423
Mailing Address - Fax:212-605-0247
Practice Address - Street 1:575 MADISON AVE
Practice Address - Street 2:SUITE 1006
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2511
Practice Address - Country:US
Practice Address - Phone:212-605-0423
Practice Address - Fax:212-605-0247
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-16
Last Update Date:2008-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11099103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist