Individual provider Active NPI

Jonathan Bentwich, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1376604207
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
016785 Issued in NY
Practice address
1230 Ave of the Americas 7TH Floor
Rockefeller Center
New York, NY 10020-1517
Phone
(646) 756-2820
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 016785 NY Primary

Addresses

Primary practice location

1230 Ave of the Americas 7TH Floor
Rockefeller Center
New York, NY 10020-1517

Mailing address

85 Fairfield Way Apt 8
Commack, NY 11725-3426
Phone (631) 486-5191

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
016785NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376604207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 FAIRFIELD WAY APT 8",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253426",
            "telephone_number": "631-486-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 AVE OF THE AMERICAS 7TH FLOOR",
            "address_2": "ROCKEFELLER CENTER",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100201517",
            "telephone_number": "646-756-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTWICH",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "016785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.