Provider Demographics
NPI:1346417557
Name:HALUSKA, KENDRA J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KENDRA
Middle Name:J
Last Name:HALUSKA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 EASTON AVE, MOB 2ND FLOOR
Mailing Address - Street 2:ST. PETERS UNIVERSITY HOSPITAL
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08907
Mailing Address - Country:US
Mailing Address - Phone:732-745-8600
Mailing Address - Fax:732-937-9428
Practice Address - Street 1:254 EASTON AVE, MOB 2ND FLOOR
Practice Address - Street 2:ST. PETERS UNIVERSITY HOSPITAL
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08907
Practice Address - Country:US
Practice Address - Phone:732-745-8600
Practice Address - Fax:732-937-9428
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017494-1103TC0700X
NJ355100490300103T00000X
NY017494103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical