Active NPI
Christine Roufail, PSY.D.
- Clinical Psychologist
- Great Neck, NY
National Provider Identifier
1083028039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 021156
- Practice address
- 310 E Shore Rd Ste 100
Great Neck, NY 11023-2432 - Phone
- (516) 466-7077
- Fax
- (516) 466-0450
- NPI assigned
- Jun 18, 2014
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 021156 | NY | Primary |
Addresses
Primary practice location
310 E Shore Rd Ste 100
Great Neck, NY 11023-2432
Mailing address
310 E Shore Rd Ste 100
Great Neck, NY 11023-2432
Phone (516) 466-7077
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 |
|---|---|---|---|
| 021156 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554854400000",
"number": "1083028039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 E SHORE RD STE 100",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110232432",
"telephone_number": "516-466-7077",
"fax_number": "516-466-0450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 E SHORE RD STE 100",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110232432",
"telephone_number": "516-466-7077",
"fax_number": "516-466-0450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUFAIL",
"first_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-18",
"last_updated": "2019-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "021156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.