Active NPI
Olivia Mary Pine, ED.M.
- School Psychologist
- New York, NY
National Provider Identifier
1053690305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2195844
- Practice address
- 123 E 7TH St Apt 5E
New York, NY 10009-5747 - Phone
- (646) 369-0833
- NPI assigned
- Aug 4, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2195844 | NY | Primary |
Addresses
Primary practice location
123 E 7TH St Apt 5E
New York, NY 10009-5747
Mailing address
123 E 7TH St Apt 5E
New York, NY 10009-5747
Phone (646) 369-0833
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2195844 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312416000000",
"number": "1053690305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "123 E 7TH ST APT 5E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100095747",
"telephone_number": "646-369-0833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 E 7TH ST APT 5E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100095747",
"telephone_number": "646-369-0833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINE",
"first_name": "OLIVIA",
"middle_name": "MARY",
"credential": "ED.M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-04",
"last_updated": "2011-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "2195844",
"primary": true
}
],
"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 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.