Individual provider Active NPI

Ilana Reich, PH.D.

  • Psychologist
  • Staten Island, NY
National Provider Identifier
1407934953
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
06077 Issued in NY
Practice address
1324 Victory Boulevard
Suite a
Staten Island, NY 10301
Phone
(718) 448-5559
Fax
(718) 815-1563
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 06077 NY Primary

Addresses

Primary practice location

1324 Victory Boulevard
Suite a
Staten Island, NY 10301

Mailing address

1324 Victory Boulevard
Suite a
Staten Island, NY 10301
Phone (718) 448-5559

Other identifiers 2

IdentifierTypeStateIssuer
0008600OtherNYGHI
146696OtherNYVALUE OPTIONS

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
06077NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407934953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 VICTORY BOULEVARD",
            "address_2": "SUITE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "718-448-5559",
            "fax_number": "718-815-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 VICTORY BOULEVARD",
            "address_2": "SUITE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10301",
            "telephone_number": "718-448-5559",
            "fax_number": "718-815-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REICH",
        "first_name": "ILANA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "06077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0008600",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "146696",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.