Provider Demographics
NPI:1881459717
Name:RICHTER, SHOSHANA MIRIAM (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHOSHANA
Middle Name:MIRIAM
Last Name:RICHTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SHOSHANA
Other - Middle Name:
Other - Last Name:MAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 BELMONT PL
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4501
Mailing Address - Country:US
Mailing Address - Phone:347-461-7017
Mailing Address - Fax:
Practice Address - Street 1:51 UPPER MONTCLAIR PLZ STE 27
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07043-1340
Practice Address - Country:US
Practice Address - Phone:973-920-3160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist