Provider Demographics
NPI:1336343995
Name:MAUSNER, JOEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:MAUSNER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 CEDARLAWN RD
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-1903
Mailing Address - Country:US
Mailing Address - Phone:914-591-8470
Mailing Address - Fax:914-591-8470
Practice Address - Street 1:34 S BROADWAY STE 600
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4428
Practice Address - Country:US
Practice Address - Phone:914-681-9435
Practice Address - Fax:914-591-8470
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010219-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01377242Medicaid
NY010219-1OtherLICENSED PSYCHOLOGIST
NY01377242Medicaid