Dr. Jewell K Waldbaum
Psychologist Health Service Clinical Psychologist
12 Hawk St
Spring Valley
, New York 10977-6104
Dr. Jewell K Waldbaum
Psychologist Health Service Clinical Psychologist
12 Hawk St
Spring Valley
, New York 10977-6104
(845) 425-0144
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About
Features
Specialties
- Psychologist
- Clinical Psychologist
- Health Service
Languages spoken
- English
Location
First Address
- Dr. Jewell K Waldbaum
- 12 Hawk St
- Spring Valley, NY
- Zip : 10977-6104
- Fax : (845) 425-0144
- Phone : (845) 356-6329
Second Address
- Dr. Jewell K Waldbaum
- 12 Hawk St
- Spring Valley, NY
- Zip : 10977-6104
- Fax : (845) 425-0144
- Phone : (845) 356-6329
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FAQs
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Is Dr. Jewell K Waldbaum a sole practitioner?
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Does Dr. Jewell K Waldbaum have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 102L00000X | Psychologist | 3934 | NY |
| N | 103T00000X | Psychologist | 3934 | NY |
| Y | 103G00000X | Clinical Psychologist | 3934 | NY |
| Y | 103TC0700X | Clinical Psychologist | 3934 | NY |
| N | 103TH0100X | Health Service | 3934 | NY |
National Provider Identifier
| NPI | 1124024005 |
|---|---|
| Provider Name | Dr. Jewell K Waldbaum |
| First Address | Spring Valley, NY 10977-6104 |
| Second Address | Spring Valley, NY 10977-6104 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/06/2005 |
| Last Update Date | 09/12/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0081767 | GHI IDENTIFICATION NUMBER (01) | |
| 3934 | NEW YORK STATE LICENSE (01) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.