Active NPI
Edward Brandman, PH.D
- Psychologist
- E Northport, NY
National Provider Identifier
1093842700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 005252
- Practice address
- 6 Selma CT
E Northport, NY 11731-6107 - Phone
- (631) 499-5909
- NPI assigned
- Feb 28, 2007
- Sex
- Male
- 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 | 005252 | NY | Primary |
Addresses
Primary practice location
6 Selma CT
E Northport, NY 11731-6107
Mailing address
6 Selma CT
E Northport, NY 11731-6107
Phone (631) 499-5909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146278 | Other | NY | VALUE OPTIONS |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005252 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093842700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 SELMA CT",
"city": "E NORTHPORT",
"state": "NY",
"postal_code": "117316107",
"telephone_number": "631-499-5909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 SELMA CT",
"city": "E NORTHPORT",
"state": "NY",
"postal_code": "117316107",
"telephone_number": "631-499-5909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDMAN",
"first_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "005252",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "146278",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in E Northport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.