Active NPI
Alan David Tishler, PSY.D.
- Clinical Psychologist
- Staten Island, NY
National Provider Identifier
1376608273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 015490
- Practice address
- 390 College Ave
Staten Island, NY 10314-2621 - Phone
- (347) 247-5965
- NPI assigned
- Dec 22, 2006
- Sex
- Male
- 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 | 015490 | NY | Primary |
Addresses
Primary practice location
390 College Ave
Staten Island, NY 10314-2621
Mailing address
390 College Avenue
Staten Island, NY 10314-2621
Phone (347) 247-5965
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015490 | Other | NY | PSYCHOLOGIST'S LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 015490 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376608273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 COLLEGE AVENUE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103142621",
"telephone_number": "347-247-5965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 COLLEGE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103142621",
"telephone_number": "347-247-5965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TISHLER",
"first_name": "ALAN",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "015490",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGIST'S LICENSE",
"identifier": "015490",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, 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.