Provider Demographics
NPI:1427678044
Name:VISCUSI, JENIFER (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENIFER
Middle Name:
Last Name:VISCUSI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 HALF MOON BAY DR
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-3120
Mailing Address - Country:US
Mailing Address - Phone:863-608-0635
Mailing Address - Fax:
Practice Address - Street 1:7 W 36TH ST FL 15
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7151
Practice Address - Country:US
Practice Address - Phone:212-203-9792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist