Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 5389 | NJ |
Y | 103TC0700X | Clinical Psychologist | 5389 | NJ |
NPI | 1982956132 |
---|---|
Provider Name | Dr. Allison J Shale Deutsch |
First Address | Saddle River, NJ 07458-3057 |
Second Address | Saddle River, NJ 07458-3057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2012 |
Last Update Date | 12/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00355940 | AGENCY MEDICAID (01) | NY |
1285628552 | AGENCY NPI (01) | NY |
WVE061 | AGENCY MEDICARE (01) | NY |