Provider Demographics
NPI:1912116443
Name:HEATH, RICHARD F (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:HEATH
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 1:46 TULIP CT
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3805
Mailing Address - Country:US
Mailing Address - Phone:845-371-0168
Mailing Address - Fax:
Practice Address - Street 1:14 RYE RIDGE PLZ
Practice Address - Street 2:SUITE 228
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-2826
Practice Address - Country:US
Practice Address - Phone:914-253-9190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9521103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical