MEDICARE: PROF. HANS-RAINER KUESELL PHD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	014097-1	NY
2	174400000X	Specialist
3	103T00000X	Psychologist	014097	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396877601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. HANS-RAINER KUESELL PHD, PHD

Provider Business Mailing Address
First Line	:	130 FT. WASHINGTON AVENUE
Second Line	:	5B
City	:	NEW YORK
State	:	NY
Zip	:	10032-4753
Country	:	US
Telephone Number	:	212-568-7714
Fax Number	:	212-568-7714

Provider Business Practice Location Address
First Line	:	130 FT. WASHINGTON AVENUE
Second Line	:	5B
City	:	NEW YORK
State	:	NY
Zip	:	10032-4753
Country	:	US
Telephone Number	:	212-568-7714
Fax Number	:	212-568-7714

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	06/11/2020

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