Individual provider Active NPI

Edward Scott O'Connor, PSY.D.

  • School Psychologist
  • Forest Hills, NY
National Provider Identifier
1386191898
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
1387032 Issued in NY
Practice address
7031 108TH St
Apt. 14B
Forest Hills, NY 11375-4424
Phone
(917) 617-7246
NPI assigned
Sep 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 1387032 NY Primary

Addresses

Primary practice location

7031 108TH St
Apt. 14B
Forest Hills, NY 11375-4424

Mailing address

7031 108TH St
Apt. 14B
Forest Hills, NY 11375-4424
Phone (917) 617-7246

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
1387032NYMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1386191898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7031 108TH ST",
            "address_2": "APT. 14B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754424",
            "telephone_number": "917-617-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 108TH ST",
            "address_2": "APT. 14B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754424",
            "telephone_number": "917-617-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "EDWARD",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "1387032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.