Maxine L Gann, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

7966 Issued in NY

Practice address

1199 Park Ave Apt 1K
New York, NY 10128-1713

Phone

(212) 860-3368

NPI assigned

Sep 13, 2021

Last updated

Sep 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maxine L. Gann Psychologist, P.C.

  • Psychologist
  • New York, NY
  • NPI 1003241225

  Clinical

  NPD (past) Authorized official

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1417626383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 PARK AVE APT 1K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281713",
            "telephone_number": "212-860-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PARK AVE APT 1K",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101281713",
            "telephone_number": "212-860-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANN",
        "first_name": "MAXINE",
        "middle_name": "L",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "6675",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "7966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Joseph Ganjian, DDS
• Pedram Ganjian
• Akshay Ganju, M.D.
• Kendra Ganley
• Ian Ganly, M.D, P.H.D
• Brighid Armstrong Gannon
• Brittany Nicole Gannon, PHD, MSN, AGPCNP-BC
• Carin Liela Gannon
• Ines Gannon
• Shannon Gannon, OTR/L

• 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 Sep 13, 2021; 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.