Craig Kordick, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021595-1 Issued in NY

Practice address

352 7TH Ave RM 1001
New York, NY 10001-5657

Phone

(917) 721-5489

NPI assigned

Oct 15, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinical Psychassociates LLP

  • Clinical Psychologist
  • New York, NY
  • NPI 1124051925
  NPD (past)

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1417282005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PARKWAY SOUTH",
            "address_2": "JACOBI MEDICAL CENTER",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10461",
            "telephone_number": "718-918-5124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 7TH AVE RM 1001",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015657",
            "telephone_number": "917-721-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDICK",
        "first_name": "CRAIG",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-15",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021595-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Korbman, PSYD
• Beatriz Korc-Grodzicki, MD
• Russell Kordas, L. AC. MS.
• Neha Korde, MD
• Mary Lee Kordes, DDS
• Alexander Kordonsky, D.D.S.
• Kore Medical
• Rachel Koreen, DO
• Koremed Inc.
• Leslie Koren

• Clinical Psychologist in New York, NY
• Providers in New York, 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 Feb 12, 2018; 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.