Provider Demographics
NPI:1396887469
Name:RICHMAN, SOPHIA (PHD)
Entity type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:
Last Name:RICHMAN
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 1:590 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07043-1206
Mailing Address - Country:US
Mailing Address - Phone:973-783-3366
Mailing Address - Fax:973-783-3006
Practice Address - Street 1:590 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:UPPER MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1206
Practice Address - Country:US
Practice Address - Phone:973-783-3366
Practice Address - Fax:973-783-3006
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004091103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist