Waldbaum, Jewell K

Waldbaum, Jewell K is an sole proprietor health care provider with primary practice located at 12 Hawk St , Spring Valley NY 10977-6104. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Health Service. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Waldbaum, Jewell K can be contacted via phone (845) 356-6329.

Contact Information

Primary practice address
12 Hawk St Spring Valley NY 10977-6104
Phone: (845) 356-6329
Fax: (845) 425-0144
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 3934 New York
Behavioral Health & Social Service Providers / Psychologist 103T00000X 3934 New York
Behavioral Health & Social Service Providers / Health Service 103TH0100X 3934 New York

Profile Details

NPI number 1124024005
LBN Legal business name Waldbaum, Jewell K
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 24th, 2005
Last updated Dec 9th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124024005 NPPES
Other 0081767 GHI IDENTIFICATION NUMBER
Other 3934 GHI IDENTIFICATION NUMBER

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