Provider Demographics
NPI:1770776734
Name:CHUSID, JUDITH F (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:F
Last Name:CHUSID
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 1:60 W 13TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7959
Mailing Address - Country:US
Mailing Address - Phone:212-463-0080
Mailing Address - Fax:212-463-0220
Practice Address - Street 1:60 W 13TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7959
Practice Address - Country:US
Practice Address - Phone:212-463-0080
Practice Address - Fax:212-463-0220
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
NY000066-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool