Active NPI
Michaela Eilleen Buckley, PHD
- Psychologist
- Merrick, NY
National Provider Identifier
1093492746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 025268
- Practice address
- 1457 Maeder Ave
Merrick, NY 11566-2044 - Phone
- (516) 589-4399
- NPI assigned
- Jul 3, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 025268 | NY | Primary |
Addresses
Primary practice location
1457 Maeder Ave
Merrick, NY 11566-2044
Mailing address
1457 Maeder Ave
Merrick, NY 11566-2044
Phone (516) 589-4399
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 025268 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1093492746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1457 MAEDER AVE",
"city": "MERRICK",
"state": "NY",
"postal_code": "115662044",
"telephone_number": "516-589-4399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1457 MAEDER AVE",
"city": "MERRICK",
"state": "NY",
"postal_code": "115662044",
"telephone_number": "516-589-4399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCKLEY",
"first_name": "MICHAELA",
"middle_name": "EILLEEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-03",
"last_updated": "2023-07-03",
"certification_date": "2023-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "025268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.