| Rudy Nydegger Phd, Abpp, Pllc | |
|
2317 Balltown Rd. Suite 203 Schenectady NY 12309 | |
| (518) 377-4398 | |
| (518) 384-3475 |
| Full Name | Rudy Nydegger Phd, Abpp, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 2317 Balltown Rd., Schenectady, New York |
| Authorized Official Name and Position | Rudy V Nydegger (OWNER) |
| Authorized Official Contact | 5183774398 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rudy Nydegger Phd, Abpp, Pllc 2317 Balltown Rd. Suite 203 Schenectady NY 12309 Ph: (518) 377-4398 | Rudy Nydegger Phd, Abpp, Pllc 2317 Balltown Rd. Suite 203 Schenectady NY 12309 Ph: (518) 377-4398 |
| NPI Number | 1255680344 |
|---|---|
| Provider Enumeration Date | 09/05/2012 |
| Last Update Date | 07/29/2014 |
| Medicare PECOS PAC ID | 7214170364 |
|---|---|
| Medicare Enrollment ID | O20130821000628 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255680344 | NPI | - | NPPES |
| 03537919 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 5721 (New York) | Primary |
| Provider Name | Rudy V Nydegger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447220090 PECOS PAC ID: 8729094271 Enrollment ID: I20060223000561 |
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