Active NPI
Jack Charles Anchin, PH.D.
- Clinical Psychologist
- Snyder, NY
National Provider Identifier
1447459680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 007199-1
- Practice address
- 4444 Main St
Snyder, NY 14226-4420 - Phone
- (716) 839-1299
- NPI assigned
- Jul 17, 2007
- Last updated
- Jul 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 007199-1 | NY | Primary |
Addresses
Primary practice location
4444 Main St
Snyder, NY 14226-4420
Mailing address
4444 Main St
Snyder, NY 14226-4420
Phone (716) 839-1299
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000500095003 | Other | NY | BLUE CROSS AND BLUE SHIEL |
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007199-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1447459680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4444 MAIN ST",
"city": "SNYDER",
"state": "NY",
"postal_code": "142264420",
"telephone_number": "716-839-1299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 MAIN ST",
"city": "SNYDER",
"state": "NY",
"postal_code": "142264420",
"telephone_number": "716-839-1299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANCHIN",
"first_name": "JACK",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-17",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "007199-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AND BLUE SHIEL",
"identifier": "000500095003",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Snyder, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.