Stephen M Koretsky, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

009372 Issued in NY

Practice address

26 Firemens Memorial Dr
Suite 113
Pomona, NY 10970-3553

Phone

(845) 354-8643

Fax

(845) 746-9083

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

Yes

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

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

Specialty

Clinical Psychologist

Education

Fordham University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1417979717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 FIREMENS MEMORIAL DR",
            "address_2": "SUITE 113",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703553",
            "telephone_number": "845-354-8643",
            "fax_number": "845-746-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 FIREMENS MEMORIAL DR",
            "address_2": "SUITE 113",
            "city": "POMONA",
            "state": "NY",
            "postal_code": "109703553",
            "telephone_number": "845-354-8643",
            "fax_number": "845-746-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORETSKY",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "009372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kayla Koenig
• Itta T Kogan, OT
• Carol Korngold, LCSW
• Bernard Steven Korotkin, RN
• Vahan S Kouyoumdjian, MD
• Lois E Kroplick, D.O.
• Barry L Krumper, MD

• Psychologist in Pomona, NY
• Providers in Pomona, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.