Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PS-009165-L | PA |
N | 103G00000X | Clinical Psychologist | PS-009165-L | PA |
N | 103TC0700X | Clinical Psychologist | PS-009165-L | PA |
NPI | 1003011552 |
---|---|
Provider Name | Dr. Randy Fingerhut |
First Address | Wynnewood, PA 19096-2139 |
Second Address | Wynnewood, PA 19096-2139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |