Provider Demographics
NPI:1639246408
Name:FEIN, RONDA LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RONDA
Middle Name:LYNN
Last Name:FEIN
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 1:3 JENNIFER CT
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-6309
Mailing Address - Country:US
Mailing Address - Phone:518-581-8699
Mailing Address - Fax:518-581-8783
Practice Address - Street 1:1 WEST AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6045
Practice Address - Country:US
Practice Address - Phone:518-581-8699
Practice Address - Fax:518-581-8783
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008738-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD0558Medicare ID - Type Unspecified