Active NPI
Maria Tsepilovan Edman, PSY.D.
- Clinical Psychologist
- New York, NY
National Provider Identifier
1477960417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 020665
- Practice address
- 1 Gustave L Levy PL
New York, NY 10029-6504 - Phone
- (718) 757-4324
- NPI assigned
- Jul 22, 2014
- Sex
- Female
- 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 | 020665 | NY | Primary |
Addresses
Primary practice location
1 Gustave L Levy PL
New York, NY 10029-6504
Mailing address
340 W 55TH St Apt 3a
New York, NY 10019-3746
Phone (718) 757-4324
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 4, 2022 through Nov 4, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020665 | NY | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405987200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405987200000",
"number": "1477960417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "340 W 55TH ST APT 3A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100193746",
"telephone_number": "718-757-4324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GUSTAVE L LEVY PL",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100296504",
"telephone_number": "718-757-4324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMAN",
"first_name": "MARIA",
"middle_name": "TSEPILOVAN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-22",
"last_updated": "2014-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "020665",
"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 Jul 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.