Provider Demographics
NPI:1598857393
Name:ALTSHULER, RICHARD JOEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOEL
Last Name:ALTSHULER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 MERRICK ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4635
Mailing Address - Country:US
Mailing Address - Phone:516-379-4414
Mailing Address - Fax:516-379-1977
Practice Address - Street 1:1955 MERRICK ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4635
Practice Address - Country:US
Practice Address - Phone:516-379-4414
Practice Address - Fax:516-379-1977
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004336103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist