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525 East 68th Sreet Box 171 Rm F-1228 Dept. Of Pyschiatry New York NY 10065-4870 | |
| (212) 746-0235 | |
| (212) 746-3687 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 525 East 68th Sreet, New York, New York |
| Authorized Official Name and Position | Zemfira Egelbaum (ACCOUNT SUPERVISOR) |
| Authorized Official Contact | 2127460235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
525 East 68th Sreet Box 171 Rm F-1228 Dept. Of Pyschiatry New York NY 10065-4870 Ph: (212) 746-0235 | 525 East 68th Sreet Box 171 Rm F-1228 Dept. Of Pyschiatry New York NY 10065-4870 Ph: (212) 746-0235 |
| NPI Number | 1871692210 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 10/25/2017 |
| Medicare PECOS PAC ID | 6800709023 |
|---|---|
| Medicare Enrollment ID | O20040712000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871692210 | NPI | - | NPPES |
| 02204644 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Francis S Lee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306909122 PECOS PAC ID: 8426043621 Enrollment ID: I20040417000006 |
| Provider Name | Robert Clark Abrams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730117342 PECOS PAC ID: 1658360847 Enrollment ID: I20040511001834 |
| Provider Name | Saira N Haider |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992027452 PECOS PAC ID: 8426039686 Enrollment ID: I20040525001194 |
| Provider Name | Darlene Mitera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689720096 PECOS PAC ID: 8426021064 Enrollment ID: I20040812001581 |
| Provider Name | Tracy Anne Butler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659430833 PECOS PAC ID: 8820059231 Enrollment ID: I20041019001463 |
| Provider Name | Eva Josephine B Harbury |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184745069 PECOS PAC ID: 8820055072 Enrollment ID: I20041220000366 |
| Provider Name | Rebecca Rendleman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104983352 PECOS PAC ID: 7517911589 Enrollment ID: I20050311000796 |
| Provider Name | Alexandra S Klufas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689744021 PECOS PAC ID: 6507893351 Enrollment ID: I20050722000603 |
| Provider Name | Joseph F Murray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003960014 PECOS PAC ID: 9032135967 Enrollment ID: I20051020000430 |
| Provider Name | Babatunde Asemota |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275620031 PECOS PAC ID: 7810914660 Enrollment ID: I20051031000789 |
| Provider Name | Judith R Cukor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366509630 PECOS PAC ID: 8527087584 Enrollment ID: I20051118000316 |
| Provider Name | Carol A Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982706719 PECOS PAC ID: 4385640648 Enrollment ID: I20061010000061 |
| Provider Name | Marcos Fe Bornstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174632822 PECOS PAC ID: 0143226118 Enrollment ID: I20061014000000 |
| Provider Name | Kimberly Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689737249 PECOS PAC ID: 2062517543 Enrollment ID: I20070411000179 |
| Provider Name | Dennis M Popeo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700811940 PECOS PAC ID: 0749387900 Enrollment ID: I20070523000004 |
| Provider Name | Amy L Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528087517 PECOS PAC ID: 6709984040 Enrollment ID: I20070609000025 |
| Provider Name | Diana Feldman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225172075 PECOS PAC ID: 2668572033 Enrollment ID: I20070713000614 |
| Provider Name | Robert E Kelly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992827117 PECOS PAC ID: 2466547260 Enrollment ID: I20071008000532 |
| Provider Name | Michael D. Mcintosh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124246962 PECOS PAC ID: 7214023290 Enrollment ID: I20071023000012 |
| Provider Name | Gail Delasho |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497717706 PECOS PAC ID: 1850488214 Enrollment ID: I20071101000107 |
| Provider Name | Jason J Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467511659 PECOS PAC ID: 8820186893 Enrollment ID: I20071109000118 |
| Provider Name | Jessica E Daniels |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134271133 PECOS PAC ID: 8628149986 Enrollment ID: I20080616000116 |
| Provider Name | Susan Samuels |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508067729 PECOS PAC ID: 1951474709 Enrollment ID: I20080728000018 |
| Provider Name | Steven D Roth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679578785 PECOS PAC ID: 2062588734 Enrollment ID: I20080903000346 |
| Provider Name | Ruth Lubelski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851347447 PECOS PAC ID: 1658449541 Enrollment ID: I20081006000103 |
| Provider Name | Mary Denise Cancellare |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063578037 PECOS PAC ID: 3375611049 Enrollment ID: I20081008000057 |
| Provider Name | John W Barnhill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699813600 PECOS PAC ID: 4183792799 Enrollment ID: I20081009000549 |
| Provider Name | P Anne Mcbride |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376630442 PECOS PAC ID: 0345398749 Enrollment ID: I20090423000005 |
| Provider Name | Sharon Hird |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780756841 PECOS PAC ID: 3173672052 Enrollment ID: I20090526000163 |
| Provider Name | Michael F Walton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114192028 PECOS PAC ID: 6901956234 Enrollment ID: I20090609000180 |
| Provider Name | Jennifer L Appollo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578896825 PECOS PAC ID: 4486792991 Enrollment ID: I20091103000461 |
| Provider Name | Marc J Dubin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114110855 PECOS PAC ID: 2365526589 Enrollment ID: I20100719000000 |
| Provider Name | Jimmy N Avari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689807851 PECOS PAC ID: 7618156233 Enrollment ID: I20110127000627 |
| Provider Name | David A Brda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558528695 PECOS PAC ID: 3971784208 Enrollment ID: I20110221000332 |
| Provider Name | Susan Matorin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992843080 PECOS PAC ID: 3779769484 Enrollment ID: I20110513000559 |
| Provider Name | Benjamin Brody |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013178318 PECOS PAC ID: 8820275373 Enrollment ID: I20110609000119 |
| Provider Name | Margaret E Hertzig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245312370 PECOS PAC ID: 3577740869 Enrollment ID: I20110614000788 |
| Provider Name | Janna S Gordon Elliott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730346768 PECOS PAC ID: 9133307192 Enrollment ID: I20110623000002 |
| Provider Name | Michele E Glover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679762546 PECOS PAC ID: 8022296474 Enrollment ID: I20110707000151 |
| Provider Name | Melanie E Sisti |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730361593 PECOS PAC ID: 3072785906 Enrollment ID: I20111018000662 |
| Provider Name | Joachim A Benitez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114990330 PECOS PAC ID: 0648291344 Enrollment ID: I20111214000616 |
| Provider Name | Kenneth Hung |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417115726 PECOS PAC ID: 4688837255 Enrollment ID: I20120517000371 |
| Provider Name | Lakshmi Reddy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689810541 PECOS PAC ID: 2163686593 Enrollment ID: I20120614000173 |
| Provider Name | Jacob R Messing |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497089668 PECOS PAC ID: 1951565381 Enrollment ID: I20120614000198 |
| Provider Name | Hengameh H Tadbiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346550621 PECOS PAC ID: 0547425803 Enrollment ID: I20120712000016 |
| Provider Name | Helen Tuson Yeh Ding |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972707925 PECOS PAC ID: 0345490272 Enrollment ID: I20121030000248 |
| Provider Name | Syed A Shamsi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982849659 PECOS PAC ID: 9739333923 Enrollment ID: I20130218000464 |
| Provider Name | Sara M Lane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265699862 PECOS PAC ID: 2163657503 Enrollment ID: I20131021000996 |
| Provider Name | Leonardo V Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659530269 PECOS PAC ID: 9234364233 Enrollment ID: I20131029001151 |
| Provider Name | Suzanne Renee Voelker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548405590 PECOS PAC ID: 1557596442 Enrollment ID: I20131031000244 |
| Provider Name | Matthew J Shear |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053601617 PECOS PAC ID: 9638305782 Enrollment ID: I20131119000883 |
| Provider Name | Alison Hermann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700048527 PECOS PAC ID: 7911133756 Enrollment ID: I20131126000925 |
| Provider Name | Richard A Friedman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891717252 PECOS PAC ID: 3971732645 Enrollment ID: I20140130000151 |
| Provider Name | Anna L Dickerman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841432499 PECOS PAC ID: 2567687692 Enrollment ID: I20140707000012 |
| Provider Name | Jonathan D Avery |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437391612 PECOS PAC ID: 6709001548 Enrollment ID: I20140710001271 |
| Provider Name | Jacqueline S Panzone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558503805 PECOS PAC ID: 2062637846 Enrollment ID: I20140711000519 |
| Provider Name | Siobhan E O'herron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811131154 PECOS PAC ID: 2466672936 Enrollment ID: I20141003001787 |
| Provider Name | Annie Li |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396902268 PECOS PAC ID: 3274704895 Enrollment ID: I20141201000071 |
| Provider Name | Joseph I Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255586830 PECOS PAC ID: 8224355045 Enrollment ID: I20150316001303 |
| Provider Name | Annaheta Salajegheh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659696565 PECOS PAC ID: 5698086437 Enrollment ID: I20150619000513 |
| Provider Name | Alma Spaniardi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831417104 PECOS PAC ID: 0244480994 Enrollment ID: I20150707002693 |
| Provider Name | Erika K Jakobson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417269739 PECOS PAC ID: 9032421714 Enrollment ID: I20150709000560 |
| Provider Name | Sean P Kerrigan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023282001 PECOS PAC ID: 6002058567 Enrollment ID: I20150818004093 |
| Provider Name | Renee Catherine Saenger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295050979 PECOS PAC ID: 7012225196 Enrollment ID: I20151009001774 |
| Provider Name | Anna Rosen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497988133 PECOS PAC ID: 0143530428 Enrollment ID: I20151117002399 |
| Provider Name | Christina R Shayevitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982979217 PECOS PAC ID: 2365745908 Enrollment ID: I20160114002170 |
| Provider Name | Jenny Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740647213 PECOS PAC ID: 2163727249 Enrollment ID: I20160227000070 |
| Provider Name | Daniel Knoepflmacher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942566682 PECOS PAC ID: 5092012112 Enrollment ID: I20160404001856 |
| Provider Name | Samantha Roche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609277268 PECOS PAC ID: 7517258361 Enrollment ID: I20160624001601 |
| Provider Name | Katherine R Goettsche |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780974725 PECOS PAC ID: 0244523876 Enrollment ID: I20160720000753 |
| Provider Name | Liliya Gershengoren |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184914939 PECOS PAC ID: 7416240064 Enrollment ID: I20160720001130 |
| Provider Name | Rachel L Moster |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609002484 PECOS PAC ID: 2567758451 Enrollment ID: I20160831002795 |
| Provider Name | Marina Rozovsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922437557 PECOS PAC ID: 7416224548 Enrollment ID: I20170522000989 |
| Provider Name | Fayrisa Greenwald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154709202 PECOS PAC ID: 7012286131 Enrollment ID: I20170706000006 |
| Provider Name | Andrew M Edelstein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295093961 PECOS PAC ID: 7214186980 Enrollment ID: I20170920003730 |
| Provider Name | Erin Chung |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952637233 PECOS PAC ID: 6507132594 Enrollment ID: I20171018002554 |
| Provider Name | Tessa Claire Hyo Goodman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770999278 PECOS PAC ID: 5193084911 Enrollment ID: I20180123003349 |
| Provider Name | Bethanie Berson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366894321 PECOS PAC ID: 6204199425 Enrollment ID: I20180420001057 |
| Provider Name | Guy Maytal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215918156 PECOS PAC ID: 5799739702 Enrollment ID: I20180510000346 |
| Provider Name | Abhishek Jaywant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306349493 PECOS PAC ID: 3870848302 Enrollment ID: I20180625000299 |
| Provider Name | Omar Ahmad Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952758609 PECOS PAC ID: 6002100708 Enrollment ID: I20180702001473 |
| Provider Name | Alice D Caesar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144563347 PECOS PAC ID: 6901152016 Enrollment ID: I20180703001437 |
| Provider Name | Nicholas J Genova |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366862153 PECOS PAC ID: 9032465984 Enrollment ID: I20180706001030 |
| Provider Name | Jessica Simberlund |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780927962 PECOS PAC ID: 5799033239 Enrollment ID: I20180731003277 |
| Provider Name | Megan D Marzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396019048 PECOS PAC ID: 7618229865 Enrollment ID: I20181016003002 |
| Provider Name | Morgan L Pacheco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467704577 PECOS PAC ID: 1052663200 Enrollment ID: I20181016003077 |
| Provider Name | Susan Karabell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053758292 PECOS PAC ID: 6608110416 Enrollment ID: I20181205002704 |
| Provider Name | Amy Parikh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437578192 PECOS PAC ID: 1254673049 Enrollment ID: I20190426000714 |
| Provider Name | Alyson Gorun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346636784 PECOS PAC ID: 1759614274 Enrollment ID: I20190614000583 |
| Provider Name | Meghan A Conroy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720406036 PECOS PAC ID: 4486993326 Enrollment ID: I20190617002229 |
| Provider Name | Lindsey Sankin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306215181 PECOS PAC ID: 4284969601 Enrollment ID: I20190708001988 |
| Provider Name | Benjamin D Zebley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669637690 PECOS PAC ID: 9436485299 Enrollment ID: I20190731003234 |
| Provider Name | Lauren H Antler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629497995 PECOS PAC ID: 4183961659 Enrollment ID: I20190910001912 |
| Provider Name | Matthew Ck Pieh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023495850 PECOS PAC ID: 9234477571 Enrollment ID: I20190919001788 |
| Provider Name | Samuel J Boas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417338112 PECOS PAC ID: 3678880713 Enrollment ID: I20191002000788 |
| Provider Name | Georgina Elizabeth Hartzell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841618139 PECOS PAC ID: 6901100098 Enrollment ID: I20191010002743 |
| Provider Name | Virginia K.a Mutch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679915169 PECOS PAC ID: 7911238134 Enrollment ID: I20191018001103 |
| Provider Name | David G Hankins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942663075 PECOS PAC ID: 7113265380 Enrollment ID: I20191029000139 |
| Provider Name | Hannah Strater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912568833 PECOS PAC ID: 1355773953 Enrollment ID: I20191120002264 |
| Provider Name | Stephen M Waugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992104459 PECOS PAC ID: 7113224718 Enrollment ID: I20200225002689 |
| Provider Name | Mark P Sullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386098762 PECOS PAC ID: 6709214448 Enrollment ID: I20200312000625 |
| Provider Name | Vasiliki Payiati- Kondos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124474887 PECOS PAC ID: 1850720343 Enrollment ID: I20200403002481 |
| Provider Name | Soudabeh Givrad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841426343 PECOS PAC ID: 2961798012 Enrollment ID: I20200416001433 |
| Provider Name | Megan Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144704842 PECOS PAC ID: 5991126120 Enrollment ID: I20200526002524 |
| Provider Name | Yunshan Gao |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518400712 PECOS PAC ID: 0941624324 Enrollment ID: I20200717001357 |
| Provider Name | Naomi Ruth Raih |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851685325 PECOS PAC ID: 1052735149 Enrollment ID: I20200722001914 |
| Provider Name | Sabina Bera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639555154 PECOS PAC ID: 7618396631 Enrollment ID: I20200924001682 |
| Provider Name | Christian P Umfrid |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063807071 PECOS PAC ID: 7810235017 Enrollment ID: I20201008000871 |
| Provider Name | Jessica Glassman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356885438 PECOS PAC ID: 5597185116 Enrollment ID: I20201021001117 |
| Provider Name | Abigail H Benudis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548794787 PECOS PAC ID: 7012255250 Enrollment ID: I20201218001752 |
| Provider Name | Heather M Kawalick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326570847 PECOS PAC ID: 3072851278 Enrollment ID: I20210105001432 |
| Provider Name | Mary-jo Curran |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1811013782 PECOS PAC ID: 9133344526 Enrollment ID: I20210113000869 |
| Provider Name | Sharon Brenda Madanes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265096754 PECOS PAC ID: 5890104442 Enrollment ID: I20210511001910 |
| Provider Name | Rachel N Knight |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437682051 PECOS PAC ID: 5193134526 Enrollment ID: I20210514000332 |
| Provider Name | Jena L Andreu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881049641 PECOS PAC ID: 5991049769 Enrollment ID: I20210720002683 |
| Provider Name | Hannah Simon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043748825 PECOS PAC ID: 7517203573 Enrollment ID: I20210721001587 |
| Provider Name | Monika A Dargis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326663493 PECOS PAC ID: 3779988159 Enrollment ID: I20211021001477 |
| Provider Name | Lauren E Oberlin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366065773 PECOS PAC ID: 2466840244 Enrollment ID: I20211027002522 |
| Provider Name | Ji Hoon Ha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609224260 PECOS PAC ID: 4183961147 Enrollment ID: I20211118002118 |
| Provider Name | Junona Elgudin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992201339 PECOS PAC ID: 3870831068 Enrollment ID: I20211201002324 |
| Provider Name | Alana Warhit |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790281293 PECOS PAC ID: 1355689514 Enrollment ID: I20211201002546 |
| Provider Name | John Hughes Mahlstedt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891172854 PECOS PAC ID: 3870888274 Enrollment ID: I20211203002165 |
| Provider Name | Karanbir S Padda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124524749 PECOS PAC ID: 0547508715 Enrollment ID: I20211216002272 |
| Provider Name | Yochai Re'em |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407352271 PECOS PAC ID: 9830437920 Enrollment ID: I20220117000008 |
| Provider Name | Tacina L Outram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427437235 PECOS PAC ID: 7719303247 Enrollment ID: I20220202001761 |
| Provider Name | Ida A Eden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740778075 PECOS PAC ID: 9335487594 Enrollment ID: I20220426002390 |
| Provider Name | Mark A Wiener |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912432618 PECOS PAC ID: 0547507949 Enrollment ID: I20220527000889 |
| Provider Name | Stephanie A Verdeflor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710637855 PECOS PAC ID: 9638558059 Enrollment ID: I20220615001273 |
| Provider Name | Jihye Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871980532 PECOS PAC ID: 2163760216 Enrollment ID: I20221004000323 |
| Provider Name | Elza L Rosen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942950357 PECOS PAC ID: 0840676409 Enrollment ID: I20221005000745 |
| Provider Name | Amanda Rose Wallace |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649665977 PECOS PAC ID: 4688953128 Enrollment ID: I20221006002563 |
| Provider Name | Mashal K Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205242898 PECOS PAC ID: 6608112941 Enrollment ID: I20221205001716 |
| Provider Name | Daniel J Eden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104314129 PECOS PAC ID: 8628317302 Enrollment ID: I20221214002226 |
| Provider Name | Benjamin A Scherban |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710411061 PECOS PAC ID: 0648518829 Enrollment ID: I20221227000785 |
| Provider Name | Eric L Goldwaser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619471323 PECOS PAC ID: 6103239579 Enrollment ID: I20230111002577 |
| Provider Name | Emily S Dumas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235661653 PECOS PAC ID: 8729316385 Enrollment ID: I20230124002165 |
| Provider Name | Nicholas A Romano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255894093 PECOS PAC ID: 1456681428 Enrollment ID: I20230124002506 |
| Provider Name | Zhenzhen Shi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598228587 PECOS PAC ID: 1759619232 Enrollment ID: I20230206000555 |
| Provider Name | Nicholas L Mascarenhas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285111450 PECOS PAC ID: 6507255395 Enrollment ID: I20230206001331 |
| Provider Name | Justin A Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932336765 PECOS PAC ID: 3476703075 Enrollment ID: I20230306001962 |
| Provider Name | Jeffrey B Anderson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043717192 PECOS PAC ID: 0042556169 Enrollment ID: I20230714000458 |
| Provider Name | Peter Justin Rossi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669976601 PECOS PAC ID: 7810324944 Enrollment ID: I20230718000187 |
| Provider Name | Juste Buneviciute |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578959748 PECOS PAC ID: 5698029494 Enrollment ID: I20230726002915 |
| Provider Name | Antara Banik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598291643 PECOS PAC ID: 0749634855 Enrollment ID: I20230922002803 |
| Provider Name | Sarah H Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073033874 PECOS PAC ID: 5496026999 Enrollment ID: I20231003000907 |
| Provider Name | Jesse A Bastiaens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194143933 PECOS PAC ID: 5799078911 Enrollment ID: I20240229003214 |
| Provider Name | Megan Hophing |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275187841 PECOS PAC ID: 3173069663 Enrollment ID: I20240719003104 |
| Provider Name | Nathan Hardy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497215693 PECOS PAC ID: 9739413543 Enrollment ID: I20240730001776 |
| Provider Name | Angela M Rios |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669935409 PECOS PAC ID: 4385972876 Enrollment ID: I20240808002647 |
| Provider Name | Emily R Hyun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902300148 PECOS PAC ID: 6305197179 Enrollment ID: I20240828001701 |
| Provider Name | Jessica L Schwartz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316407638 PECOS PAC ID: 4284962689 Enrollment ID: I20240904002322 |
| Provider Name | Rachel Zambrowicz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578127445 PECOS PAC ID: 3971831447 Enrollment ID: I20240904003708 |
| Provider Name | Alexandra H Yoon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427511237 PECOS PAC ID: 1355882002 Enrollment ID: I20240920001851 |
| Provider Name | Christopher Brennan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639852163 PECOS PAC ID: 4688106636 Enrollment ID: I20241015002158 |
| Provider Name | Stephanie Angel Eng |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174084552 PECOS PAC ID: 6608119938 Enrollment ID: I20241024003021 |
| Provider Name | Julia C. Tartaglia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770103384 PECOS PAC ID: 3971036682 Enrollment ID: I20241101000677 |
Joan Poelvoorde Lcsw Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 W 34th St, Penthouse, New York, NY 10001 Phone: 646-473-0138 Fax: 646-473-0138 | |
Laurie D Gilkes Lcsw Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 330 E 79th St, Suite 1g, New York, NY 10075 Phone: 212-737-0560 Fax: 212-737-0560 | |
National Federation For Autism Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 336 Fort Washington Ave, First Floor, New York, NY 10033 Phone: 917-783-2431 | |
Mary E Genkins Dsw Lcsw Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 430 E 63rd St, Apt 12l, New York, NY 10065 Phone: 212-838-9257 Fax: 212-207-6615 | |
Rethink Autism Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 19 W 21st Street, Suite 403, New York, NY 10010 Phone: 917-658-6313 | |