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General NPI Number Information
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NPI Number | 1427706076
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Entity Type | Individual
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Provider Name | RENEE S SOUFER PHD
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Gender | Female
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Dates
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Enumeration Date | 03/14/2022
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 1425 MADISON AVE FL 4
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City | NEW YORK
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State | NY
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Zip | 10029-6514
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Country | US
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Telephone | 650-422-4011
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Fax |
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Provider Business Mailing Address
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Address Line | 31 CHAPEL LN
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City | RIVERSIDE
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State | CT
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Zip | 06878-1615
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Country | US
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Telephone | 650-422-4011
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Fax |
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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 | 027294
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License Number State | NY
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