Organization Active NPI

Robert B. Devinney, PH.D. Psychologist PC

  • Clinical Neuropsychologist
  • Patchogue, NY
National Provider Identifier
1114049871
Registry record updated Apr 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
012661 Issued in NY
Legal business name
ROBERT B. DEVINNEY, PH.D. PSYCHOLOGIST PC
Practice address
105 Medford Ave
Patchogue, NY 11772-1223
Phone
(631) 987-3780
Fax
(631) 204-0069
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert B. Devinney, PH.D.NPI 1184922056
Title
President
Phone
(631) 987-3780

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 012661 NY Primary
Addiction (Substance Use Disorder) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0400X 012661 NY
Adult Development & Aging PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TA0700X 012661 NY
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 012661 NY
Rehabilitation PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TR0400X 012661 NY

Addresses

Primary practice location

105 Medford Ave
Patchogue, NY 11772-1223

Mailing address

40 High St
Southampton, NY 11968-4061
Phone (631) 987-3780

National Provider Directory

National Provider Directory

Locations

2956 Medford Ave
Medford, NY 11763
Phone (631) 987-3780

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303862400000",
    "number": "1114049871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HIGH ST",
            "city": "SOUTHAMPTON",
            "state": "NY",
            "postal_code": "119684061",
            "telephone_number": "631-987-3780",
            "fax_number": "845-340-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MEDFORD AVE",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117721223",
            "telephone_number": "631-987-3780",
            "fax_number": "631-204-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT B. DEVINNEY, PH.D. PSYCHOLOGIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2011-04-27",
        "status": "A",
        "authorized_official_last_name": "DEVINNEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-987-3780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "012661",
            "primary": true
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "012661",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "012661",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012661",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": "NY",
            "license": "012661",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.