Active NPI
Adam M. Brickman, PH.D.
- Clinical Neuropsychologist
- New York, NY
National Provider Identifier
1013109230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 017174
- Practice address
- 615 Fort Washington Ave
#3D
New York, NY 10040-3954 - Phone
- (646) 641-0616
- NPI assigned
- Aug 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 017174 | NY | Primary |
| Psychologist | 103T00000X | 017174 | NY |
Addresses
Primary practice location
615 Fort Washington Ave
#3D
New York, NY 10040-3954
Mailing address
615 Fort Washington Ave
#3D
New York, NY 10040-3954
Phone (646) 641-0616
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
| License | State | Type | Specialty |
|---|---|---|---|
| 017174 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186790400000",
"number": "1013109230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 FORT WASHINGTON AVE",
"address_2": "#3D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100403954",
"telephone_number": "646-641-0616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 FORT WASHINGTON AVE",
"address_2": "#3D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100403954",
"telephone_number": "646-641-0616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRICKMAN",
"first_name": "ADAM",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-11",
"last_updated": "2007-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NY",
"license": "017174",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "017174",
"primary": false
}
],
"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 Aug 11, 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.