Brennan Pedersen

Primary specialty

Psychoanalysis PsychologistTaxonomy code 103TP0814X

License

001153 Issued in NY

Practice address

31 Washington SQ W Ste 6B
New York, NY 10011-9126

Phone

(206) 890-7816

NPI assigned

Aug 29, 2022

Last updated

Aug 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1003536343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 BUTLER ST APT 3R",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112314989",
            "telephone_number": "206-890-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 WASHINGTON SQ W STE 6B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100119126",
            "telephone_number": "206-890-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "BRENNAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NY",
            "license": "001153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie Pecord
• Jillian Pecoriello, MD
• Charlotte Pecot, MD
• Dhanashri Peddawad
• Angela Noelle Peddle, O.D.
• Britta Pedersen, MD
• Hilda Pedersen, M.B. CH.B.
• Julia Yasek Pedersen, DNP
• Alexis Pederson, MD
• Justin Pederson, RN, AGACNP

• Psychoanalysis Psychologist in New York, NY
• Providers in New York, NY by specialty
• Psychoanalysis Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.