Active NPI
Alan Dienstag, PSY.D.
- Clinical Psychologist
- Bronx, NY
National Provider Identifier
1104098946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 010176
- Practice address
- 525 West 238TH St
4J
Bronx, NY 10463-1846 - Phone
- (917) 301-4622
- Fax
- (718) 543-5204
- NPI assigned
- Apr 1, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 010176 | NY | Primary |
Addresses
Primary practice location
525 West 238TH St
4J
Bronx, NY 10463-1846
Mailing address
525 West 238TH St
4J
Bronx, NY 10463-1846
Phone (917) 301-4622
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 |
|---|---|---|---|
| 010176 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207008000000",
"number": "1104098946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 WEST 238TH ST",
"address_2": "4J",
"city": "BRONX",
"state": "NY",
"postal_code": "104631846",
"telephone_number": "917-301-4622",
"fax_number": "718-543-5204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 WEST 238TH ST",
"address_2": "4J",
"city": "BRONX",
"state": "NY",
"postal_code": "104631846",
"telephone_number": "917-301-4622",
"fax_number": "718-543-5204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIENSTAG",
"first_name": "ALAN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-01",
"last_updated": "2008-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "010176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.