Active NPI
Ellen Jaffe, PSYD
- Psychologist
- Bellerose, NY
National Provider Identifier
1154092088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 011506-1
- Practice address
- 7403 Commonwealth Blvd
Bellerose, NY 11426-1839 - Phone
- (646) 996-6405
- NPI assigned
- Sep 21, 2021
- 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 | 011506-1 | NY | Primary |
Addresses
Primary practice location
7403 Commonwealth Blvd
Bellerose, NY 11426-1839
Mailing address
401 E 74TH St Apt 14G
New York, NY 10021-3929
Phone (646) 398-0212
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 |
|---|---|---|---|
| 011506-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1154092088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E 74TH ST APT 14G",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100213929",
"telephone_number": "646-398-0212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7403 COMMONWEALTH BLVD",
"city": "BELLEROSE",
"state": "NY",
"postal_code": "114261839",
"telephone_number": "646-996-6405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAFFE",
"first_name": "ELLEN",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-21",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "011506-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellerose, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.