Healthcare Provider Details

I. General information

NPI: 1629281589
Provider Name (Legal Business Name): ALBA LUDMER PSYCHOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 W RIDGEWOOD AVE
RIDGEWOOD NJ
07450-3199
US

IV. Provider business mailing address

299 RICHARDS RD
RIDGEWOOD NJ
07450-1009
US

V. Phone/Fax

Practice location:
  • Phone: 201-670-1870
  • Fax:
Mailing address:
  • Phone: 201-652-5491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number35SI00266600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: