Derek Seder, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

023181 Issued in NY

Practice address

3512 Quentin Rd Ste 110
Brooklyn, NY 11234

Phone

(800) 275-3243

NPI assigned

Feb 12, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1396201661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD STE 110",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112344245",
            "telephone_number": "800-275-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 QUENTIN RD STE 110",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11234",
            "telephone_number": "800-275-3243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3512 Quentin Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "11234",
            "country_code": "US",
            "telephone_number": "800-275-3243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEDER",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY27964",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Brooklyn, NY
• Providers in Brooklyn, 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 Apr 9, 2019; 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.