Provider Demographics
NPI:1386974418
Name:REPHUAH HEALTH PSYCHOLOGY PC
Entity type:Organization
Organization Name:REPHUAH HEALTH PSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-956-1440
Mailing Address - Street 1:60 DUNNING RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2215
Mailing Address - Country:US
Mailing Address - Phone:845-956-1440
Mailing Address - Fax:845-956-1440
Practice Address - Street 1:60 DUNNING RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2215
Practice Address - Country:US
Practice Address - Phone:845-956-1440
Practice Address - Fax:845-956-1440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011019103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Single Specialty