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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. JASON MARC RUDOLPH, PSY.D.

Active

DR. JASON MARC RUDOLPH, PSY.D. is a Clinical Psychologist healthcare provider located in WAINSCOTT, New York. NPI 1174404016 is currently active in the NPPES registry. Verify at CMS.

Clinical Psychologist · WAINSCOTT, NY

Registration Details

NPI Number
1174404016
Provider Type
Individual
Gender
Male
NPI Issued
Sep 9, 2025 (0.94508593362167 yrs)
Last Updated
Sep 9, 2025
Licenses
35868 (CA)
017306 (NY)

Practice Information

Address
48 SOUTH BREEZE DRIVE
WAINSCOTT, NY, 11975
Browse NY providers · Browse ZIP 11975
Phone
9177508400
Primary Specialty
Clinical Psychologist
103TC0700X
Additional Specialty
Clinical Psychologist

Other Clinical Psychologist Providers in WAINSCOTT, NY

Name Credential NPI
DR. JOEL L KAYE PH.D. 1639297666
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.