Healthcare Provider Details

I. General information

NPI: 1528788031
Provider Name (Legal Business Name): MS. JUDITH ANNE TANEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W 60TH ST FL 4
NEW YORK NY
10023-7905
US

IV. Provider business mailing address

INSTITUTE OF CONTEMPORARY PSYCHOTHERAPY 4TH FLOOR
NEW YORK NY
10023
US

V. Phone/Fax

Practice location:
  • Phone: 212-333-3444
  • Fax:
Mailing address:
  • Phone: 212-333-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number001303
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: