Jairo A. Gonzalez, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

023716 Issued in NY

Practice address

345 7TH Ave
RM 1601J
New York, NY 10001-5006

Phone

(917) 740-4440

NPI assigned

Jul 26, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Orli Health Professional Corporation

  • Adult Medicine Physician
  • New York, NY
  • NPI 1376341982

  Psychologist

  NPD (past)

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1447703459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 7TH AVE",
            "address_2": "RM 1601J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015006",
            "telephone_number": "917-740-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 7TH AVE",
            "address_2": "RM 1601J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015006",
            "telephone_number": "917-740-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JAIRO",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "023716",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Gonzalez
• Hilaury Gonzalez, LCSW
• Issael Gonzalez
• Ivette Gonzalez
• Izabel Starr Gonzalez, PA-S
• Jamie P Gonzalez
• Janice Gonzalez
• Javier Anthony Gonzalez
• Jennifer Gonzalez
• Jennifer Gonzalez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; 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.