Individual provider Active NPI

John J. Munk, PH.D.

  • Psychologist
  • Staten Island, NY
National Provider Identifier
1023232360
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6505 Issued in NY
Practice address
657 Castleton Ave
Staten Island, NY 10301
Phone
(718) 448-9775
Fax
(718) 448-6072
NPI assigned
Apr 11, 2007
Sex
Male
Sole proprietor
No

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
Psychologist 103T00000X 6505 NY Primary

Addresses

Primary practice location

657 Castleton Ave
Staten Island, NY 10301

Mailing address

82-28 250TH St
Bellerose, NY 11426-2524
Phone (718) 347-7815

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6505NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023232360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82-28 250TH ST",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114262524",
            "telephone_number": "718-347-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "718-448-9775",
            "fax_number": "718-448-6072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNK",
        "first_name": "JOHN",
        "middle_name": "J.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "6505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, 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.