Eleanor a Siegel

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00107300 Issued in NJ

Legal business name

ELEANOR A SIEGEL

Practice address

495 Iron Bridge Rd
Suite 8
Freehold, NJ 07728-3069

Phone

(732) 294-9694

Fax

(732) 294-7470

NPI assigned

Apr 23, 2007

Organization subpart

No

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

Authorized official

Name

Eleanor A Siegel, PHD

Title

Owner

Phone

(732) 294-9694

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306064753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 IRON BRIDGE RD",
            "address_2": "SUITE 8",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283069",
            "telephone_number": "732-294-9694",
            "fax_number": "732-294-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 IRON BRIDGE RD",
            "address_2": "SUITE 8",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077283069",
            "telephone_number": "732-294-9694",
            "fax_number": "732-294-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEANOR A SIEGEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-294-9694",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00107300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY PLUS",
            "identifier": "00314000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "105113",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "00314000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4220195",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.