Healthcare Provider Details
I. General information
NPI: 1134143142
Provider Name (Legal Business Name): RICHARD JAMES GELMAN PSY. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
978 ROUTE 45 NORTHSIDE PLAZA SUITE L-7
POMONA NY
10970-3521
US
IV. Provider business mailing address
20 GLEN DR
SOUTH SALEM NY
10590-2309
US
V. Phone/Fax
- Phone: 845-354-4315
- Fax:
- Phone: 914-763-8906
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 8573 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: