Active NPI
Igor Davidson, PH.D.
- Psychologist
- Brooklyn, NY
National Provider Identifier
1447274378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 016113-1
- Practice address
- 2928 Brighton 8TH St
Brooklyn, NY 11235-6381 - Phone
- (718) 541-9074
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 016113-1 | NY | Primary |
Addresses
Primary practice location
2928 Brighton 8TH St
Brooklyn, NY 11235-6381
Mailing address
2928 Brighton 8TH St
Brooklyn, NY 11235-6381
Phone (718) 541-9074
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016113-1 | Other | NY | LICENSE |
| 02596463 | Medicaid | NY |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016113-1 | NY | MD | Psychologist |
| 016113 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quarry Road Emergency Services P.C. | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Bronx, NY
- NPI 1740595917
-
- Emergency Medicine Physician
- Bronx, NY
- NPI 1134238199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193356800000",
"number": "1447274378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2928 BRIGHTON 8TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112356381",
"telephone_number": "718-541-9074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2928 BRIGHTON 8TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112356381",
"telephone_number": "718-541-9074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "IGOR",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "016113-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "016113-1",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02596463",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.