Provider Demographics
NPI:1457568255
Name:JUSTER, HARLAN RICHARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:HARLAN
Middle Name:RICHARD
Last Name:JUSTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 CAMDEN CIR
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-9668
Mailing Address - Country:US
Mailing Address - Phone:518-229-3501
Mailing Address - Fax:
Practice Address - Street 1:950 NEW LOUDON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2100
Practice Address - Country:US
Practice Address - Phone:518-229-3501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8949103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral