Individual provider Active NPI

Lara Brodzinsky, PSY.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1386009272
Registry record updated Dec 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
68 021308 Issued in NY
Practice address
229 W 60TH St Apt 23T
New York, NY 10023-7515
Phone
(917) 415-8959
NPI assigned
Dec 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 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 68 021308 NY Primary

Addresses

Primary practice location

229 W 60TH St Apt 23T
New York, NY 10023-7515

Mailing address

229 W 60TH St Apt 23T
New York, NY 10023-7515
Phone (917) 415-8959

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

State licenses

LicenseStateTypeSpecialty
68 021308NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450656000000",
    "number": "1386009272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W 60TH ST APT 23T",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237515",
            "telephone_number": "917-415-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W 60TH ST APT 23T",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237515",
            "telephone_number": "917-415-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODZINSKY",
        "first_name": "LARA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "68 021308",
            "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 Dec 21, 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.