| Rubenzahl, Knudsen & Associates Psych., Srvcs, P.c. | |
|
22670 Summit Drive Suite 2 Watertown NY 13601 | |
| (315) 788-3332 | |
| (315) 788-4584 |
| Full Name | Rubenzahl, Knudsen & Associates Psych., Srvcs, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 22670 Summit Drive, Watertown, New York |
| Authorized Official Name and Position | Thomas E. Knudsen (OWNER) |
| Authorized Official Contact | 3157883332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rubenzahl, Knudsen & Associates Psych., Srvcs, P.c. 22670 Summit Drive Suite 2 Watertown NY 13601 Ph: (315) 788-3332 | Rubenzahl, Knudsen & Associates Psych., Srvcs, P.c. 22670 Summit Drive Suite 2 Watertown NY 13601 Ph: (315) 788-3332 |
| NPI Number | 1578552170 |
|---|---|
| Provider Enumeration Date | 10/17/2005 |
| Last Update Date | 09/26/2014 |
| Medicare PECOS PAC ID | 2860461076 |
|---|---|
| Medicare Enrollment ID | O20040924000837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578552170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 009513 (New York) | Primary |
| Provider Name | Thomas E Knudsen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841256716 PECOS PAC ID: 4587666060 Enrollment ID: I20070213000308 |
| Provider Name | Erica M Freeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013241942 PECOS PAC ID: 0941432819 Enrollment ID: I20140407002080 |
| Provider Name | Megan E Mcrae |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902152465 PECOS PAC ID: 5991001281 Enrollment ID: I20160314000369 |
| Provider Name | Heather M Mcmanaman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073062378 PECOS PAC ID: 2466735907 Enrollment ID: I20170208001099 |
| Provider Name | Samuel A Rubenzahl |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770539454 PECOS PAC ID: 5193047355 Enrollment ID: I20180827000330 |
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