Active NPI
Nancy Peterson, PHD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1215087655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 016177
- Practice address
- 200 E 33Rd St Apt 31J
New York, NY 10016-4832 - Phone
- (212) 725-0192
- Fax
- (914) 285-5723
- NPI assigned
- Jan 10, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 016177 | NY | Primary |
Addresses
Primary practice location
200 E 33Rd St Apt 31J
New York, NY 10016-4832
Mailing address
209 Lincoln PL Apt 8D
Brooklyn, NY 11217-3712
Phone (718) 964-8331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386686855 | Other | NY | PSYCHIATRIST |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child & Family Medical, PLLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215087655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 LINCOLN PL APT 8D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112173712",
"telephone_number": "718-964-8331",
"fax_number": "914-285-5723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E 33RD ST APT 31J",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100164832",
"telephone_number": "212-725-0192",
"fax_number": "914-285-5723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "NANCY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "016177",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHIATRIST",
"identifier": "1386686855",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.