Active NPI
Judith L Dulberg, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Poughkeepsie, NY
National Provider Identifier
1194035972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- F404171
- Practice address
- 370 Violet Ave
Poughkeepsie, NY 12601-1034 - Phone
- (845) 471-1807
- Fax
- (845) 471-1815
- NPI assigned
- Oct 14, 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F404171 | NY | Primary |
Addresses
Primary practice location
370 Violet Ave
Poughkeepsie, NY 12601-1034
Mailing address
11 Crum Elbow Rd
Hyde Park, NY 12538-2852
Phone (845) 229-1020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163W00000X | Medicaid | NY |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F404171 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705363200000",
"number": "1194035972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 CRUM ELBOW RD",
"city": "HYDE PARK",
"state": "NY",
"postal_code": "125382852",
"telephone_number": "845-229-1020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 VIOLET AVE",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126011034",
"telephone_number": "845-471-1807",
"fax_number": "845-471-1815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DULBERG",
"first_name": "JUDITH",
"middle_name": "L",
"credential": "PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-14",
"last_updated": "2024-01-16",
"certification_date": "2024-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NY",
"license": "F404171",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "163W00000X",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poughkeepsie, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.