Kelly Zanetich, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

020280 Issued in NY

Practice address

25 Central Park W
1L
New York, NY 10023-7253

Phone

(201) 777-0596

NPI assigned

Sep 28, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1380326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380326400000",
    "number": "1184051690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 GARDEN ST",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070304305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CENTRAL PARK W",
            "address_2": "1L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237253",
            "telephone_number": "201-777-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANETICH",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-28",
        "last_updated": "2013-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "020280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie O. Zandieh, MD, MS
• Irwin Zandman, DDS
• Debra Zane, MD
• Mariana Zane, M.D.
• Neil H Zane, DDS
• Anano Zangaladze, MD
• Nicholas Andrew Zangaladze
• Nikki Zangenah
• Ashley Zanghi, PSY.D.
• William Martin Zangwill, PH.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.