Provider Demographics
NPI:1720536485
Name:PROUJANSKY, RACHEL A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:A
Last Name:PROUJANSKY
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 1:519 8TH AVE RM 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-4582
Mailing Address - Country:US
Mailing Address - Phone:212-683-3339
Mailing Address - Fax:212-683-3340
Practice Address - Street 1:519 8TH AVE RM 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-4582
Practice Address - Country:US
Practice Address - Phone:212-683-3339
Practice Address - Fax:212-683-3340
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022175103TC0700X
NYP02969103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical