Active NPI
Eileen A Potamos
- Psychoanalyst
- New York, NY
National Provider Identifier
1003456435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychoanalyst
- License
- 000434-1
- Practice address
- 60 W 13TH St PH a
New York, NY 10011-7915 - Phone
- (917) 750-0776
- NPI assigned
- Jan 14, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | 000434-1 | NY | Primary |
Addresses
Primary practice location
60 W 13TH St PH a
New York, NY 10011-7915
Mailing address
1108 Cypress Trace Dr
Melbourne, FL 32940-1619
Phone (917) 750-0776
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 |
|---|---|---|---|
| 000434-1 | NY | MD | Psychoanalyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578960000000",
"number": "1003456435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1108 CYPRESS TRACE DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329401619",
"telephone_number": "917-750-0776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 W 13TH ST PH A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100117915",
"telephone_number": "917-750-0776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTAMOS",
"first_name": "EILEEN",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-14",
"last_updated": "2020-01-14",
"certification_date": "2020-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NY",
"license": "000434-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.