Active NPI
Nicole Brezel, LMSW, PSYD
- Psychologist
- Woodside, NY
National Provider Identifier
1003439753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 027015
- Practice address
- 4277 65TH PL
Woodside, NY 11377-5054 - Phone
- (718) 429-2000
- NPI assigned
- May 28, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 027015 | NY | Primary |
Addresses
Primary practice location
4277 65TH PL
Woodside, NY 11377-5054
Mailing address
55 E 87TH St # 11FG
New York, NY 10128-1043
Phone (516) 592-3847
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027015 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1590624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1003439753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 E 87TH ST # 11FG",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101281043",
"telephone_number": "516-592-3847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4277 65TH PL",
"city": "WOODSIDE",
"state": "NY",
"postal_code": "113775054",
"telephone_number": "718-429-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREZEL",
"first_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "LMSW, PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-28",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "027015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodside, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.