Provider Demographics
NPI:1962160770
Name:WACHSLER, JUDITH
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:WACHSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:BLUMENTHAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1335 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4697
Mailing Address - Country:US
Mailing Address - Phone:718-253-5990
Mailing Address - Fax:
Practice Address - Street 1:4111 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5894
Practice Address - Country:US
Practice Address - Phone:718-875-6900
Practice Address - Fax:718-875-6999
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health