Active NPI
Elysa R Safran
- Psychologist
- New York, NY
National Provider Identifier
1285149302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 017278-1
- Practice address
- 799 Broadway Ste 510
New York, NY 10003-6811 - Phone
- (917) 653-4891
- Fax
- (917) 653-4891
- NPI assigned
- Dec 12, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 017278-1 | NY | Primary |
Addresses
Primary practice location
799 Broadway Ste 510
New York, NY 10003-6811
Mailing address
308 W 73Rd St Apt 3B
New York, NY 10023-1664
Phone (917) 653-4891
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017278-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513036800000",
"number": "1285149302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 W 73RD ST APT 3B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100231664",
"telephone_number": "917-653-4891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "799 BROADWAY STE 510",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100036811",
"telephone_number": "917-653-4891",
"fax_number": "917-653-4891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAFRAN",
"first_name": "ELYSA",
"middle_name": "R",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-12",
"last_updated": "2017-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "017278-1",
"primary": true
}
],
"identifiers": [],
"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 Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.