Individual provider Active NPI

Benjamin Warach

  • Psychologist
  • New York, NY
National Provider Identifier
1417676032
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
025092 Issued in NY
Practice address
99 Wall St Ste 487
New York, NY 10005-4301
Phone
(646) 434-8646
NPI assigned
Aug 25, 2022
Last updated
Apr 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 025092 NY Primary

Addresses

Primary practice location

99 Wall St Ste 487
New York, NY 10005-4301

Mailing address

99 Wall St Ste 487
New York, NY 10005-4301
Phone (646) 434-8646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 1, 2026 through Apr 1, 2028

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1417676032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 WALL ST STE 487",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100054301",
            "telephone_number": "646-434-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 WALL ST STE 487",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100054301",
            "telephone_number": "646-434-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARACH",
        "first_name": "BENJAMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "025092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.