Park East Psychological Assoc, P.C.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

006485 Issued in NY

Legal business name

PARK EAST PSYCHOLOGICAL ASSOC, P.C.

Practice address

3 East 68 St.
New York, NY 10065

Phone

(212) 628-9200

Fax

(212) 472-7253

NPI assigned

Aug 16, 2011

Organization subpart

No

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

Authorized official

Name

Jerry Alan Lublin, PH.D.

Title

Assistant Director

Phone

(212) 628-9200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1184903577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 EAST 68 ST.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "212-628-9200",
            "fax_number": "212-472-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 EAST 68 ST.",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10065",
            "telephone_number": "212-628-9200",
            "fax_number": "212-472-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK EAST PSYCHOLOGICAL ASSOC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "LUBLIN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "212-628-9200",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "NY",
            "license": "006485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.