Mark Pezner, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

012059 Issued in NY

Practice address

3 Carpenter PL
Sea Cliff, NY 11579-2103

Phone

(917) 407-5008

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  NPD (past)

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1356398705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CARPENTER PL",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115792103",
            "telephone_number": "917-407-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CARPENTER PL",
            "city": "SEA CLIFF",
            "state": "NY",
            "postal_code": "115792103",
            "telephone_number": "917-407-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZNER",
        "first_name": "MARK",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Andreno Norful, ANP-BC
• North Coast Internal Medicine, P.C.
• North Shore Central School District
• Marjorie Ruth O'Connor, L.AC.
• Karen B Pegno, LMSW
• Muireann Phelan, LMSW
• Noelle Pigott
• Sita Devi Pirozzi
• Carol Renee Pohrille, LCSW
• Kristen Pulzone, M.S., CCC-SLP

• Clinical Psychologist in Sea Cliff, NY
• Providers in Sea Cliff, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.