Dina Eva Kalnicki

Individual provider Active NPI Psychologist · Riverdale, NY

NPI 1023328606 · NPPES record last updated Oct 12, 2012

Key facts

NPI
1023328606
Entity type
Individual (NPI type 1)
Primary specialty
Psychologist 103T00000X
Practice address
521 W 239TH St
Riverdale, NY 10463
Phone
(718) 601-7805
NPI assigned
Oct 15, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Yes

Addresses

Primary practice location

521 W 239TH St
Riverdale, NY 10463

Mailing address

1156 N Broadway
Andrus
Yonkers, NY 10701-1108

Other identifiers

IdentifierTypeStateIssuer
WVE061OtherNYAGENCY MEDICARE
00355940OtherNYAGENCY MEDICAID
1285628552OtherNYAGENCY NPI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 12, 2012.

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1023328606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1156 N BROADWAY",
            "address_2": "ANDRUS",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W 239TH ST",
            "city": "RIVERDALE",
            "state": "NY",
            "postal_code": "10463",
            "telephone_number": "718-601-7805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALNICKI",
        "first_name": "DINA",
        "middle_name": "EVA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICARE",
            "identifier": "WVE061",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICAID",
            "identifier": "00355940",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY NPI",
            "identifier": "1285628552",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, NY

All providers in Riverdale, NY · Psychologist in New York

Sources for this page

Verify at the official NPI Registry.