Provider Demographics
NPI:1447382791
Name:FUND, RUCHAMA SEIDMAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RUCHAMA
Middle Name:SEIDMAN
Last Name:FUND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4201
Mailing Address - Country:US
Mailing Address - Phone:718-252-3440
Mailing Address - Fax:718-758-0281
Practice Address - Street 1:1280 E 12TH ST APT 3C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5231
Practice Address - Country:US
Practice Address - Phone:718-252-3440
Practice Address - Fax:718-758-0281
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9334103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV60901Medicare ID - Type Unspecified