NPIMap

Organization Active NPI

Daniel M Rudofossi PSYD PHD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1184065674
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DANIEL M RUDOFOSSI PSYD PHD
Practice address
4 Park Ave
Suite 10F
New York, NY 10016-5339
Phone
(917) 836-0635
NPI assigned
Jul 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Authorized official

Name
Jenny Rubin
Title
Billing/Credentialing
Phone
(718) 926-3804

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

4 Park Ave
Suite 10F
New York, NY 10016-5339

Mailing address

4 Park Ave
Suite 10F
New York, NY 10016-5339
Phone (917) 836-0635

National Provider Directory

National Provider Directory

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": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373500800000",
    "number": "1184065674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PARK AVE",
            "address_2": "SUITE 10F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165339",
            "telephone_number": "917-836-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PARK AVE",
            "address_2": "SUITE 10F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165339",
            "telephone_number": "917-836-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL M RUDOFOSSI PSYD PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING",
        "authorized_official_telephone_number": "718-926-3804"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 11, 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.

Verify at the official NPI Registry.