Provider Demographics
NPI:1073721189
Name:RATH, JOSEPH F (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:RATH
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 1:411 E 10TH ST
Mailing Address - Street 2:#20C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-4227
Mailing Address - Country:US
Mailing Address - Phone:212-263-6183
Mailing Address - Fax:
Practice Address - Street 1:660 1ST AVE
Practice Address - Street 2:ROOM 748
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3295
Practice Address - Country:US
Practice Address - Phone:212-263-6183
Practice Address - Fax:212-263-0453
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014844103G00000X, 103T00000X, 103TC0700X, 103TC1900X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02582507Medicaid
NYVM5221Medicare ID - Type Unspecified