Individual provider Active NPI

Betsy Landau, PHD

  • Psychologist
  • Forest Hills, NY
National Provider Identifier
1295890325
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
008781-1 Issued in NY
Practice address
9415 69TH Ave
Forest Hills, NY 11375-5857
Phone
(718) 268-5829
Fax
(718) 575-9667
NPI assigned
Dec 27, 2006
Last updated
Sep 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 008781-1 NY Primary

Addresses

Primary practice location

9415 69TH Ave
Forest Hills, NY 11375-5857

Mailing address

9415 69TH Ave
Forest Hills, NY 11375-5857
Phone (718) 268-5829

Other identifiers 3

IdentifierTypeStateIssuer
V4A311OtherNYBLUE CROSS/BLUE SHIELD
011025OtherNYVALUE OPTIONS
01145275MedicaidNY

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
008781-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1295890325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 69TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755857",
            "telephone_number": "718-268-5829",
            "fax_number": "718-575-9667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9415 69TH AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755857",
            "telephone_number": "718-268-5829",
            "fax_number": "718-575-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAU",
        "first_name": "BETSY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "008781-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "V4A311",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "011025",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01145275",
            "state": "NY"
        }
    ],
    "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 Sep 22, 2010; 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.