Individual provider Active NPI

Caryn Gorden, PSY. D.

  • Psychologist
  • New York, NY
National Provider Identifier
1053434167
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
014408 Issued in NY
Practice address
140 Riverside Drive
Suite 1-0
New York, NY 10024
Phone
(212) 579-1705
Fax
(212) 579-1706
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 014408 NY Primary

Addresses

Primary practice location

140 Riverside Drive
Suite 1-0
New York, NY 10024

Mailing address

140 Riverside Drive
Suite 1-0
New York, NY 10024
Phone (212) 579-1705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140603000019 NY Practitioner - Clinical Psychologist 9537382031 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

590 W End Ave
1C
New York, NY 10024-1749
Phone (212) 579-1705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014408NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237420800000",
    "number": "1053434167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 RIVERSIDE DRIVE",
            "address_2": "SUITE 1-0",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "212-579-1705",
            "fax_number": "212-579-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 RIVERSIDE DRIVE",
            "address_2": "SUITE 1-0",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10024",
            "telephone_number": "212-579-1705",
            "fax_number": "212-579-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDEN",
        "first_name": "CARYN",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2009-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "014408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.