Provider Demographics
NPI:1144461617
Name:BESSERMAN, JUDITH B (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:B
Last Name:BESSERMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PEACEABLE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:10590-1503
Mailing Address - Country:US
Mailing Address - Phone:914-763-6114
Mailing Address - Fax:
Practice Address - Street 1:3 PEACEABLE ST
Practice Address - Street 2:
Practice Address - City:SOUTH SALEM
Practice Address - State:NY
Practice Address - Zip Code:10590-1503
Practice Address - Country:US
Practice Address - Phone:914-763-6114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0184511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical