New York Psychological Wellness, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

018595 Issued in NY

Legal business name

NEW YORK PSYCHOLOGICAL WELLNESS, PC

Practice address

4640 Springfield Blvd
Bayside, NY 11361-3517

Phone

(718) 225-5505

NPI assigned

Jun 2, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Robert S. Meyers, PSYDNPI 1295067304

Title

Director

Phone

(718) 225-5505

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert S. Meyers, PSYD

  • Psychologist
  • Bayside, NY
  • NPI 1295067304
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1401667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1477965978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 SPRINGFIELD BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613517",
            "telephone_number": "718-225-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 SPRINGFIELD BLVD",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113613517",
            "telephone_number": "718-225-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK PSYCHOLOGICAL WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-02",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "MEYERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-225-5505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "018595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Bayside, NY
• Providers in Bayside, 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 Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.