Individual provider Active NPI

Rachel Shari Liberman Czosniak, PSYD

  • Clinical Psychologist
  • Bronx, NY
National Provider Identifier
1477361384
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
026975 Issued in NY
Practice address
1400 Pelham Pkwy S BLDG 6
Bronx, NY 10461-1119
Phone
(718) 918-6523
NPI assigned
Dec 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 026975 NY Primary

Addresses

Primary practice location

1400 Pelham Pkwy S BLDG 6
Bronx, NY 10461-1119

Mailing address

471 Keap St Apt 3a
Brooklyn, NY 11211-3460
Phone (347) 254-2224

Other practice location 1

166 Cow Neck Rd
Port Washington, NY 11050-1117
Phone (347) 254-2224

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923001371 NY Order and Referring Only - Clinical Psychologist 8820593890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
026975NYMDSpeech-Language Pathologist

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

NPI Registry JSON

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1477361384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "471 KEAP ST APT 3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112113460",
            "telephone_number": "347-254-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S BLDG 6",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611119",
            "telephone_number": "718-918-6523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 Cow Neck Rd",
            "address_purpose": "LOCATION",
            "city": "Port Washington",
            "state": "NY",
            "postal_code": "110501117",
            "country_code": "US",
            "telephone_number": "347-254-2224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CZOSNIAK",
        "first_name": "RACHEL",
        "middle_name": "SHARI LIBERMAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "026975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.