Donna Ann Attivissimo, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

012838 Issued in NY

Practice address

103 Fort Salonga Rd Ste 2
Fort Salonga, NY 11768-1454

Phone

(631) 987-0913

NPI assigned

Mar 22, 2022

Last updated

Mar 22, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1386393882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 FORT SALONGA RD STE 2",
            "city": "FORT SALONGA",
            "state": "NY",
            "postal_code": "117681454",
            "telephone_number": "631-987-0913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FORT SALONGA RD STE 2",
            "city": "FORT SALONGA",
            "state": "NY",
            "postal_code": "117681454",
            "telephone_number": "631-987-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTIVISSIMO",
        "first_name": "DONNA ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Fort Salonga, NY
• Providers in Fort Salonga, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.