Organization Active NPI

Metropolitan Neuropsychological Consulting P.C.

  • Psychologist
  • Fort Lee, NJ
National Provider Identifier
1154627073
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
SI4788 Issued in NJ
Legal business name
METROPOLITAN NEUROPSYCHOLOGICAL CONSULTING P.C.
Practice address
440 West St
Suite 302
Fort Lee, NJ 07024
Phone
(917) 757-6707
NPI assigned
Feb 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Authorized official

Name
Dr. Marina Shikhman, PH.D.NPI 1578795480
Title
Owner
Phone
(917) 757-6707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X SI4788 NJ Primary

Addresses

Primary practice location

440 West St
Suite 302
Fort Lee, NJ 07024

Mailing address

1530 Palisade Ave
#25C
Fort Lee, NJ 07024-5471
Phone (917) 757-0381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110311000623 NJ Part B Supplier - Clinic/Group Practice 4587846555 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lee, NJ

National Provider Directory

National Provider Directory

Locations

2460 Lemoine Ave
Ste 400
Fort Lee, NJ 07024
Phone (201) 970-1080

440 West St
Ste 302
Fort Lee, NJ 07024
Phone (917) 757-6707

440 West St
#302
Fort Lee, NJ 07024
Phone (917) 757-6707

2337 Lemoine Ave
Fort Lee, NJ 07024
Phone (201) 927-9786

2337 Lemoine Ave
#104
Fort Lee, NJ 07024
Phone (917) 757-0381

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": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672272000000",
    "number": "1154627073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "address_2": "#25C",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "917-757-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 WEST ST",
            "address_2": "SUITE 302",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "917-757-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN NEUROPSYCHOLOGICAL CONSULTING P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "SHIKHMAN",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-757-6707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SI4788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.