Leota Susan Branche, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0096651 Issued in NY

Practice address

1651 Third Avenue
Iptar
Ny, NY 10128

Phone

(914) 262-3985

Fax

(914) 723-2731

NPI assigned

Jul 28, 2008

Last updated

Jan 9, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Dr. Susan Susan Branche Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1164687364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 OLD JACKSON AVE UNIT 19",
            "city": "HASTINGS ON HUDSON",
            "state": "NY",
            "postal_code": "107063231",
            "telephone_number": "914-262-3985",
            "fax_number": "914-723-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 THIRD AVENUE",
            "address_2": "IPTAR",
            "city": "NY",
            "state": "NY",
            "postal_code": "10128",
            "telephone_number": "914-262-3985",
            "fax_number": "914-723-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCHE",
        "first_name": "LEOTA",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009665-1",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009665",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0096651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BRANCHE",
            "middle_name": "SUSAN",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jeanette Bernardino-Pascual, RN
• Jeffrey Marc Bernstein, PT
• Sherrie Blanchette, RD
• Eustacia Tulabot Bleza, M.D.
• Phyllis Bloom, LSW, L.AC.
• Brenda Luisa Brathwaite, CMN
• Kristina Ann Brielmaier, F.N.P
• Rebecca Cecile Brightman, MD
• Anne-Marie Beluang Brillantes, M.D.
• Cindy Brody, PHD

• Clinical Psychologist in Ny, NY
• Providers in Ny, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; 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.