Provider Demographics
NPI:1992130058
Name:GERSHUNY, BETH S (PHD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:S
Last Name:GERSHUNY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6369 MILL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1406
Mailing Address - Country:US
Mailing Address - Phone:845-516-4688
Mailing Address - Fax:
Practice Address - Street 1:6369 MILL ST
Practice Address - Street 2:SUITE 101
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1406
Practice Address - Country:US
Practice Address - Phone:845-516-4688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015633103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical