Active NPI
Sue B. Avedon, PSYD
- Psychologist
- East Hampton, NY
National Provider Identifier
1336551654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 010448-1
- Practice address
- 174 Buckskill Rd.
East Hampton, NY 11937 - Phone
- (631) 329-1830
- NPI assigned
- May 21, 2014
- Last updated
- May 21, 2014
- 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 | 010448-1 | NY | Primary |
Addresses
Primary practice location
174 Buckskill Rd.
East Hampton, NY 11937
Mailing address
174 Buckskill Rd
East Hampton, NY 11937
Phone (631) 329-1830
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010448-1 | NY | MD | Speech-Language Pathologist |
| 010448 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400630400000",
"number": "1336551654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "174 BUCKSKILL RD",
"city": "EAST HAMPTON",
"state": "NY",
"postal_code": "11937",
"telephone_number": "631-329-1830",
"fax_number": "631-329-1830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "174 BUCKSKILL RD.",
"city": "EAST HAMPTON",
"state": "NY",
"postal_code": "11937",
"telephone_number": "631-329-1830"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVEDON",
"first_name": "SUE",
"middle_name": "B.",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-21",
"last_updated": "2014-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "010448-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Hampton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.