Provider Demographics
NPI:1265640924
Name:SHUSTER, RICKIE SUE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RICKIE
Middle Name:SUE
Last Name:SHUSTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:SUE
Other - Last Name:SHUSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:161 WEST 16TH ST
Mailing Address - Street 2:APT 12H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6206
Mailing Address - Country:US
Mailing Address - Phone:212-741-1121
Mailing Address - Fax:212-475-2116
Practice Address - Street 1:80 EAST 11TH ST
Practice Address - Street 2:SUITE 510
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-475-1669
Practice Address - Fax:212-475-2116
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010393103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist