Provider Demographics
NPI:1407168495
Name:CUDDY, CAMILLA ZOE (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:CAMILLA
Middle Name:ZOE
Last Name:CUDDY
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 1:180 E END AVE
Mailing Address - Street 2:APARTMENT 16B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7763
Mailing Address - Country:US
Mailing Address - Phone:917-912-6667
Mailing Address - Fax:
Practice Address - Street 1:180 E END AVE
Practice Address - Street 2:APARTMENT 16B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-7763
Practice Address - Country:US
Practice Address - Phone:917-912-6667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015985-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical