Individual provider Active NPI

Janet S. Klosko, PH.D.

  • Psychologist
  • Great Neck, NY
National Provider Identifier
1417019118
Registry record updated Apr 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
10331 Issued in NY
Practice address
11 Middle Neck Rd
Ste 312
Great Neck, NY 11021-2301
Phone
(516) 466-8485
NPI assigned
Dec 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 10331 NY Primary

Addresses

Primary practice location

11 Middle Neck Rd
Ste 312
Great Neck, NY 11021-2301

Mailing address

450 Ohayo Mountain Rd
Woodstock, NY 12498-2516
Phone (845) 657-9809

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090612000349 NY Practitioner - Clinical Psychologist 2466502448 Practice locations: Great Neck, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11 Middle Neck Rd
Suite 312
Great Neck, NY 11021-2301
Phone (516) 466-8485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10331NYMDPsychologist
010331NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492819200000",
    "number": "1417019118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 OHAYO MOUNTAIN RD",
            "city": "WOODSTOCK",
            "state": "NY",
            "postal_code": "124982516",
            "telephone_number": "845-657-9809",
            "fax_number": "845-657-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MIDDLE NECK RD",
            "address_2": "STE 312",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212301",
            "telephone_number": "516-466-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOSKO",
        "first_name": "JANET",
        "middle_name": "S.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-16",
        "last_updated": "2017-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "10331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

Verify at the official NPI Registry.