Individual provider Active NPI

Christopher Mesopotanese, PSY.D.

  • Psychologist
  • Springfield, NJ
National Provider Identifier
1366819948
Registry record updated Aug 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35S100529000 Issued in NJ
Practice address
28 Millburn Ave
Suite 7
Springfield, NJ 07081-1039
Phone
(732) 648-3359
NPI assigned
Aug 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 35S100529000 NJ Primary

Addresses

Primary practice location

28 Millburn Ave
Suite 7
Springfield, NJ 07081-1039

Mailing address

28 Millburn Ave
Suite 7
Springfield, NJ 07081-1039
Phone (732) 648-3359

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

State licenses

LicenseStateTypeSpecialty
35S100529000NJMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1440892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440892800000",
    "number": "1366819948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 MILLBURN AVE",
            "address_2": "SUITE 7",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811039",
            "telephone_number": "732-648-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MILLBURN AVE",
            "address_2": "SUITE 7",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811039",
            "telephone_number": "732-648-3359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESOPOTANESE",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-30",
        "last_updated": "2015-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35S100529000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2015; 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.