Active NPI
Kristin Moyer Fandl, CSWR
- Psychologist
- Wappinger Falls, NY
National Provider Identifier
1144372210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- R042767
- Practice address
- 15 Myers Colner Rd
Hollowbrook Suite 1B
Wappinger Falls, NY 12590 - Phone
- (845) 298-1910
- Fax
- (845) 226-1327
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- No
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 | R042767 | NY | Primary |
Addresses
Primary practice location
15 Myers Colner Rd
Hollowbrook Suite 1B
Wappinger Falls, NY 12590
Mailing address
15 Myers Colner Rd
Hollowbrook Suite 1B
Wappinger Falls, NY 12590
Phone (845) 298-1910
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 |
|---|---|---|---|
| R042767 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144372210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 MYERS COLNER RD",
"address_2": "HOLLOWBROOK SUITE 1B",
"city": "WAPPINGER FALLS",
"state": "NY",
"postal_code": "12590",
"telephone_number": "845-298-1910",
"fax_number": "845-226-1327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 MYERS COLNER RD",
"address_2": "HOLLOWBROOK SUITE 1B",
"city": "WAPPINGER FALLS",
"state": "NY",
"postal_code": "12590",
"telephone_number": "845-298-1910",
"fax_number": "845-226-1327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANDL",
"first_name": "KRISTIN",
"middle_name": "MOYER",
"credential": "CSWR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "R042767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wappinger Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.