Individual provider Active NPI

Jonathan A Javitch, M.D., PH.D.

  • Psychiatry Physician
  • New York, NY
National Provider Identifier
1427296177
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
172890 Issued in NY
Practice address
630 W 168TH St
Center for Molecular Recognition, P&S 11-401
New York, NY 10032-3725
Phone
(212) 305-7308
Fax
(775) 898-5133
NPI assigned
Feb 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 172890 NY Primary

Addresses

Primary practice location

630 W 168TH St
Center for Molecular Recognition, P&S 11-401
New York, NY 10032-3725

Mailing address

630 W 168TH St
Center for Molecular Recognition, P&S 11-401
New York, NY 10032-3725
Phone (212) 305-7308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
172890NYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1427296177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "address_2": "CENTER FOR MOLECULAR RECOGNITION, P&S 11-401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-7308",
            "fax_number": "775-898-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W 168TH ST",
            "address_2": "CENTER FOR MOLECULAR RECOGNITION, P&S 11-401",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323725",
            "telephone_number": "212-305-7308",
            "fax_number": "775-898-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVITCH",
        "first_name": "JONATHAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "172890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.