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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WVE061 | Other | NY | AGENCY MEDICARE |
| 00355940 | Other | NY | AGENCY MEDICAID |
| 1285628552 | Other | NY | AGENCY NPI |
NPI Registry JSON
{
"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
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.