Individual provider Active NPI

Allan Abraham Cassorla, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1396877627
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
008886-1 Issued in NY
Practice address
375 W End Ave
Suite 1D
New York, NY 10024-6568
Phone
(212) 787-4643
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 008886-1 NY Primary

Addresses

Primary practice location

375 W End Ave
Suite 1D
New York, NY 10024-6568

Mailing address

375 W End Ave
Suite 1D
New York, NY 10024-6568
Phone (212) 787-4643

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Mar 7, 2017 through Mar 7, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
008886-1NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396877627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 W END AVE",
            "address_2": "SUITE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246568",
            "telephone_number": "212-787-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 W END AVE",
            "address_2": "SUITE 1D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246568",
            "telephone_number": "212-787-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSORLA",
        "first_name": "ALLAN",
        "middle_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "008886-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.