Active NPI
Janet L Etzi, PSYD
- Psychologist
- Philadelphia, PA
National Provider Identifier
1124113873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS005770L
- Practice address
- 18 Druim Moir LN
Philadelphia, PA 19118-4134 - Phone
- (215) 264-4625
- NPI assigned
- Oct 4, 2006
- 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 | PS005770L | PA | Primary |
Addresses
Primary practice location
18 Druim Moir LN
Philadelphia, PA 19118-4134
Mailing address
18 Druim Moir LN
Philadelphia, PA 19118-4134
Phone (215) 264-4625
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377907200000",
"number": "1124113873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 DRUIM MOIR LN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191184134",
"telephone_number": "215-264-4625"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 DRUIM MOIR LN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191184134",
"telephone_number": "215-264-4625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETZI",
"first_name": "JANET",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2013-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS005770L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.