Active NPI
Ayxa Calero-Breckheimer, PHD
- Psychologist
- New York, NY
National Provider Identifier
1174834352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 018429-1
- Practice address
- 285 W End Ave
Suite 3Y
New York, NY 10023-2504 - Phone
- (347) 435-6498
- Fax
- (646) 476-9814
- NPI assigned
- Jun 23, 2010
- 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 | 018429-1 | NY | Primary |
Addresses
Primary practice location
285 W End Ave
Suite 3Y
New York, NY 10023-2504
Mailing address
164 Paulin Blvd
Leonia, NJ 07605-1236
Phone (201) 585-0757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 018429-1 | Other | NY | PSYCHOLOGIST LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018429-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370304000000",
"number": "1174834352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "164 PAULIN BLVD",
"city": "LEONIA",
"state": "NJ",
"postal_code": "076051236",
"telephone_number": "201-585-0757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 W END AVE",
"address_2": "SUITE 3Y",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100232504",
"telephone_number": "347-435-6498",
"fax_number": "646-476-9814"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALERO-BRECKHEIMER",
"first_name": "AYXA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-23",
"last_updated": "2013-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "018429-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST LICENSE",
"identifier": "018429-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.