Individual provider Active NPI

Roseanne Gotterbarn

  • Psychologist
  • Westbury, NY
National Provider Identifier
1316299290
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
010304 Issued in NY
Practice address
718 The Plain Rd
Westbury, NY 11590-5956
Phone
(516) 478-5533
Fax
(516) 478-5543
NPI assigned
Oct 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 010304 NY Primary

Addresses

Primary practice location

718 The Plain Rd
Westbury, NY 11590-5956

Mailing address

718 The Plain Rd
Westbury, NY 11590-5956
Phone (516) 478-5533

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

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1316299290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 THE PLAIN RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905956",
            "telephone_number": "516-478-5533",
            "fax_number": "516-478-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 THE PLAIN RD",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115905956",
            "telephone_number": "516-478-5533",
            "fax_number": "516-478-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTERBARN",
        "first_name": "ROSEANNE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "010304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.