Individual provider Active NPI

Maryann Diviney Juska, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1003936048
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011969 Issued in NY
Practice address
120 E 56TH St RM 710
New York, NY 10022-3662
Phone
(212) 486-8162
Fax
(212) 486-8163
NPI assigned
Mar 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 011969 NY Primary

Addresses

Primary practice location

120 E 56TH St RM 710
New York, NY 10022-3662

Mailing address

120 E 56TH St
#710
New York, NY 10022-3607
Phone (212) 486-8162

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
011969NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003936048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E 56TH ST",
            "address_2": "#710",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223607",
            "telephone_number": "212-486-8162",
            "fax_number": "212-486-8163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E 56TH ST RM 710",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223662",
            "telephone_number": "212-486-8162",
            "fax_number": "212-486-8163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSKA",
        "first_name": "MARYANN",
        "middle_name": "DIVINEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011969",
            "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 Jul 8, 2007; 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.