NPIMap

Organization Active NPI

North Fork Neuropsychology

  • Clinical Psychologist
  • Medford, NY
National Provider Identifier
1225309339
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
NORTH FORK NEUROPSYCHOLOGY
Practice address
12 Platinum CT
Medford, NY 11763-2247
Phone
(631) 875-2748
Fax
(480) 247-4658
NPI assigned
Jan 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Authorized official

Name
Dr. Celine Marie Paillot, PH.D.
Title
Founder and Owner
Phone
(631) 875-2748

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X

Addresses

Primary practice location

12 Platinum CT
Medford, NY 11763-2247

Mailing address

12 Platinum CT
Medford, NY 11763-2247
Phone (631) 875-2748

National Provider Directory

National Provider Directory
Tax ID family
North Fork Neuropsychology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327017600000",
    "number": "1225309339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PLATINUM CT",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632247",
            "telephone_number": "631-875-2748",
            "fax_number": "480-247-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 PLATINUM CT",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632247",
            "telephone_number": "631-875-2748",
            "fax_number": "480-247-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FORK NEUROPSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-20",
        "last_updated": "2012-01-20",
        "status": "A",
        "authorized_official_last_name": "PAILLOT",
        "authorized_official_first_name": "CELINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "FOUNDER AND OWNER",
        "authorized_official_telephone_number": "631-875-2748",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.