Damian Michael Gerlach Elias, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019554 Issued in NY

Practice address

1140 Broadway
Ste 204
New York, NY 10001-7504

Phone

(215) 327-2504

NPI assigned

Mar 31, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1235428145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 5TH ST",
            "address_2": "APT #2B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153534",
            "telephone_number": "215-327-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BROADWAY",
            "address_2": "STE 204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100017504",
            "telephone_number": "215-327-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAS",
        "first_name": "DAMIAN",
        "middle_name": "MICHAEL GERLACH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-31",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE NUMBER",
            "identifier": "019554",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shella Eliacin, LCSW
• Nicholas Russel Elian
• Alan Cristobal Elias
• Alicia Elias
• Arthur Elias, DMD
• Erica Jade Elias, M.S. CCC-SLP
• Evelyn Elias
• Harold Kunal Elias, M.D.
• Jenna Elias
• Jonathan Edmond Elias, M.D.

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.