Active NPI
Eunja Park Talbot, PSY.D,
- Clinical Neuropsychologist
- Jackson, NJ
National Provider Identifier
1083931323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 5187
- Practice address
- 23 Hardwood Dr
Jackson, NJ 08527-5349 - Phone
- (917) 968-8209
- NPI assigned
- Apr 27, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 68019961 | NY | |
| Psychologist | 103T00000X | 5187 | NJ | |
| Psychologist | 103T00000X | 68019961 | NY | |
| Clinical Neuropsychologist | 103G00000X | 5187 | NJ | Primary |
Addresses
Primary practice location
23 Hardwood Dr
Jackson, NJ 08527-5349
Mailing address
23 Hardwood Dr
Jackson, NJ 08527-5349
Phone (917) 968-8209
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | eptpsychology@gmail.com | Health Information Exchange (HIE) |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68019961 | NY | MD | Clinical Neuropsychologist |
| 5187 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603756800000",
"number": "1083931323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 HARDWOOD DR",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085275349",
"telephone_number": "917-968-8209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 HARDWOOD DR",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085275349",
"telephone_number": "917-968-8209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALBOT",
"first_name": "EUNJA",
"middle_name": "PARK",
"name_prefix": "Dr.",
"credential": "PSY.D,",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-27",
"last_updated": "2020-10-27",
"certification_date": "2020-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NY",
"license": "68019961",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "5187",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "68019961",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NJ",
"license": "5187",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "eptpsychology@gmail.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "23 Hardwood Dr",
"city": "Jackson",
"state": "NJ",
"country_code": "US",
"postal_code": "085275349",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jackson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.