Provider Demographics
NPI:1568580959
Name:KUPPERSMITH, JUDITH CAROLYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:CAROLYN
Last Name:KUPPERSMITH
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 1:1 IRVING PL
Mailing Address - Street 2:G12F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-9701
Mailing Address - Country:US
Mailing Address - Phone:212-505-6806
Mailing Address - Fax:
Practice Address - Street 1:1 IRVING PL
Practice Address - Street 2:G12F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-9701
Practice Address - Country:US
Practice Address - Phone:212-505-6806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000622103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis