Provider Demographics
NPI:1376389445
Name:PUDER, JANICE (PHD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:PUDER
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 1:1133 BROADWAY STE 1220
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-7961
Mailing Address - Country:US
Mailing Address - Phone:845-521-5231
Mailing Address - Fax:
Practice Address - Street 1:1133 BROADWAY STE 1220
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-7961
Practice Address - Country:US
Practice Address - Phone:845-521-5231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist