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NPI Code Detail

MEDICARE: DR. JORJA REDWAY PH.D.

MEDICARE: DR. JORJA REDWAY PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist021909NY

General Provider Information

NPI Number : 1710385570
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORJA REDWAY PH.D.
Provider Business Mailing Address
First Line : 205 HUDSON ST FL 9
Second Line :
City : NEW YORK
State : NY
Zip : 10013-1810
Country : US
Telephone Number : 646-491-9868
Fax Number :
Provider Business Practice Location Address
First Line : 205 HUDSON ST FL 9
Second Line :
City : NEW YORK
State : NY
Zip : 10013-1810
Country : US
Telephone Number : 646-491-9868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2014
Last Update Date : 03/30/2025

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Directions to “ DR. JORJA REDWAY PH.D.” Practice Location

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