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General NPI Number Information
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NPI Number | 1265640924
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Entity Type | Individual
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Provider Name | RICKIE SUE SHUSTER PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 80 EAST 11TH ST SUITE 510
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-475-1669
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Fax | 212-475-2116
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Provider Business Mailing Address
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Address Line | 161 WEST 16TH ST APT 12H
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City | NEW YORK
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State | NY
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Zip | 10011-6206
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Country | US
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Telephone | 212-741-1121
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Fax | 212-475-2116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 010393
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License Number State | NY
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