Provider Demographics
NPI:1487770301
Name:COBB, JUDITH H (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:H
Last Name:COBB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:410 CENTRAL PARK WEST
Mailing Address - Street 2:APT. 12B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-866-8004
Mailing Address - Fax:212-866-8004
Practice Address - Street 1:20 W 86TH ST
Practice Address - Street 2:# 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3604
Practice Address - Country:US
Practice Address - Phone:212-724-7760
Practice Address - Fax:212-866-8004
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008793-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist