DR. Jason Marc Rudolph, PSY.D.

NPI #1174404016 in Wainscott, New York

Provider Information

NPI Number: 1174404016
Entity Type: Individual
Name: DR. Jason Marc Rudolph, PSY.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Clinical
Credential: PSY.D.
Enumeration Date: Sep 9, 2025
Last Updated: Sep 9, 2025

Practice Location

Address: 48 SOUTH BREEZE DRIVE
City: Wainscott
State: New York
ZIP Code: 11975
Phone: (917) 750-8400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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