Active NPI
Nadia Zein Hidayatallah, PSY.D.
- Psychologist
- New York, NY
National Provider Identifier
1104232156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 020666
- Practice address
- 411 W 114TH St
New York, NY 10025-1710 - Phone
- (212) 523-4885
- NPI assigned
- Jul 9, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 020666 | NY | Primary |
Addresses
Primary practice location
411 W 114TH St
New York, NY 10025-1710
Mailing address
411 W 114TH St
New York, NY 10025-1710
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 17, 2021 through May 17, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020666 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404864000000",
"number": "1104232156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 W 114TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100251710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 W 114TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100251710",
"telephone_number": "212-523-4885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIDAYATALLAH",
"first_name": "NADIA",
"middle_name": "ZEIN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-09",
"last_updated": "2014-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "020666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.