Active NPI
Deborah Kraidman
- Marriage & Family Therapist
- New York, NY
National Provider Identifier
1124879333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- P118318
- Practice address
- 1619 3Rd Ave RM 202
New York, NY 10128-3459 - Phone
- (718) 490-8665
- NPI assigned
- Mar 27, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 002278 | NY | |
| Marriage & Family Therapist | 106H00000X | P118318 | Primary |
Addresses
Primary practice location
1619 3Rd Ave RM 202
New York, NY 10128-3459
Mailing address
10420 Queens Blvd Apt 17L
Forest Hills, NY 11375-3610
Phone (718) 490-8665
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002278 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714694400000",
"number": "1124879333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10420 QUEENS BLVD APT 17L",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113753610",
"telephone_number": "718-490-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1619 3RD AVE RM 202",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101283459",
"telephone_number": "718-490-8665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAIDMAN",
"first_name": "DEBORAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-27",
"last_updated": "2024-05-03",
"certification_date": "2024-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NY",
"license": "002278",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": "P118318",
"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 May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.