Individual provider Active NPI

David Marshall Anderson, PH.D.

  • Psychologist
  • New York, NY
National Provider Identifier
1396995247
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
020659 Issued in NY
Practice address
101 E 56TH St
New York, NY 10022
Phone
(646) 625-4315
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 020659 NY Primary

Addresses

Primary practice location

101 E 56TH St
New York, NY 10022

Mailing address

101 E 56TH St
New York, NY 10022-2661
Phone (646) 625-4315

Other practice location 1

1000 Veteran Ave
Los Angeles, CA 90024-2704
Phone (818) 267-2727

Other practice location 2

101 E 56th St
New York, NY 10022
Phone (646) 625-4315

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
020659NYMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1396995247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E 56TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100222661",
            "telephone_number": "646-625-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E 56TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10022",
            "telephone_number": "646-625-4315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Veteran Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900242704",
            "country_code": "US",
            "telephone_number": "818-267-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E 56th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10022",
            "country_code": "US",
            "telephone_number": "646-625-4315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "DAVID",
        "middle_name": "MARSHALL",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-29",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "020659",
            "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 Aug 27, 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.