Active NPI
Frederick Scott Kadushin, PH.D.
- Clinical Neuropsychologist
- Longmeadow, MA
National Provider Identifier
1104037670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 5067
- Practice address
- 136 Dwight Rd
Longmeadow, MA 01106-1759 - Phone
- (413) 567-2008
- Fax
- (413) 451-0020
- NPI assigned
- May 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 5067 | MA | Primary |
Addresses
Primary practice location
136 Dwight Rd
Longmeadow, MA 01106-1759
Mailing address
84 Ellington St
Longmeadow, MA 01106-1430
Phone (413) 567-2008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104037670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 ELLINGTON ST",
"city": "LONGMEADOW",
"state": "MA",
"postal_code": "011061430",
"telephone_number": "413-567-2008",
"fax_number": "413-451-0020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 DWIGHT RD",
"city": "LONGMEADOW",
"state": "MA",
"postal_code": "011061759",
"telephone_number": "413-567-2008",
"fax_number": "413-451-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KADUSHIN",
"first_name": "FREDERICK",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "5067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longmeadow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.