Organization Active NPI

Kanaris Psychological Services PC

  • Psychologist
  • Smithtown, NY
National Provider Identifier
1144205105
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
KANARIS PSYCHOLOGICAL SERVICES PC
Practice address
496 Smithtown Byp
#304
Smithtown, NY 11787-5005
Phone
(631) 979-2640
Fax
(631) 979-2684
NPI assigned
Dec 13, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Peter S Kanaris, PHD
Title
Psychologist/President
Phone
(631) 979-2640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

496 Smithtown Byp
#304
Smithtown, NY 11787-5005

Mailing address

496 Smithtown Byp
#304
Smithtown, NY 11787-5005
Phone (631) 979-2640

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144205105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "#304",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-979-2640",
            "fax_number": "631-979-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SMITHTOWN BYP",
            "address_2": "#304",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875005",
            "telephone_number": "631-979-2640",
            "fax_number": "631-979-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANARIS PSYCHOLOGICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KANARIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PSYCHOLOGIST/PRESIDENT",
        "authorized_official_telephone_number": "631-979-2640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.