Active NPI
Robert Nachtman, PH.D
- Clinical Psychologist
- Holbrook, NY
National Provider Identifier
1144341652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4492
- Practice address
- 233 Union Ave Ste 101
Holbrook, NY 11741-1813 - Phone
- (631) 979-7728
- Fax
- (631) 366-4816
- NPI assigned
- Apr 2, 2007
- Last updated
- Jun 5, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 4492 | NY | Primary |
Addresses
Primary practice location
233 Union Ave Ste 101
Holbrook, NY 11741-1813
Mailing address
25204 Anns Choice Way
Warminster, PA 18974-3363
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110602000359 | NY | Practitioner - Clinical Psychologist | 2163607888 | Practice locations: Hauppage, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1144341652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25204 ANNS CHOICE WAY",
"city": "WARMINSTER",
"state": "PA",
"postal_code": "189743363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 UNION AVE STE 101",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117411813",
"telephone_number": "631-979-7728",
"fax_number": "631-366-4816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NACHTMAN",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "4492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.