NPIMap

Organization Active NPI

Long Island Geriatric Psychological Services P.C.

  • Clinical Psychologist
  • Forest Hills, NY
National Provider Identifier
1225474968
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
015238-1 Issued in NY
Legal business name
LONG ISLAND GERIATRIC PSYCHOLOGICAL SERVICES P.C.
Practice address
118-35 Queens Blvd
Suite 1403
Forest Hills, NY 11375-7205
Phone
(718) 268-6600
NPI assigned
May 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Authorized official

Name
Susan J Hall, PH.D.
Title
President
Phone
(718) 268-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 015238-1 NY Primary

Addresses

Primary practice location

118-35 Queens Blvd
Suite 1403
Forest Hills, NY 11375-7205

Mailing address

118-35 Queens Blvd
Suite 1403
Forest Hills, NY 11375-7205
Phone (718) 268-6600

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1225474968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118-35 QUEENS BLVD",
            "address_2": "SUITE 1403",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757205",
            "telephone_number": "718-268-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118-35 QUEENS BLVD",
            "address_2": "SUITE 1403",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757205",
            "telephone_number": "718-268-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND GERIATRIC PSYCHOLOGICAL SERVICES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-268-6600",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015238-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.