Active NPI
Gloria S. Rothenberg, PH. D.
- Clinical Psychologist
- Merrick, NY
National Provider Identifier
1366544066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 8041-1
- Practice address
- 1674 Meadowbrook Rd
Merrick, NY 11566-2505 - Phone
- (516) 223-9318
- NPI assigned
- Sep 2, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 8041-1 | NY | Primary |
Addresses
Primary practice location
1674 Meadowbrook Rd
Merrick, NY 11566-2505
Mailing address
1674 Meadowbrook Rd
Merrick, NY 11566-2505
Phone (516) 223-9318
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100318000050 | NY | Practitioner - Clinical Psychologist | 6608901459 | Practice locations: Merrick, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8041-1 | NY | MD | Clinical Psychologist |
| 008041 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366544066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1674 MEADOWBROOK RD",
"city": "MERRICK",
"state": "NY",
"postal_code": "115662505",
"telephone_number": "516-223-9318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1674 MEADOWBROOK RD",
"city": "MERRICK",
"state": "NY",
"postal_code": "115662505",
"telephone_number": "516-223-9318"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTHENBERG",
"first_name": "GLORIA",
"middle_name": "S.",
"credential": "PH. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "8041-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.