Individual provider Active NPI

Staci Beth Friedman-Weiner, PSY.D.

  • Psychologist
  • Great Neck, NY
National Provider Identifier
1487771390
Registry record updated Apr 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
016138 Issued in NY
Practice address
45 N Station PLZ
Suite 210
Great Neck, NY 11021-5011
Phone
(917) 526-0766
NPI assigned
Mar 23, 2007
Last updated
Apr 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 016138 NY Primary

Addresses

Primary practice location

45 N Station PLZ
Suite 210
Great Neck, NY 11021-5011

Mailing address

180 E 79TH St
Suite 1C
New York, NY 10075-0437
Phone (516) 643-0303

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

State licenses

LicenseStateTypeSpecialty
016138NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272412800000",
    "number": "1487771390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E 79TH ST",
            "address_2": "SUITE 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750437",
            "telephone_number": "516-643-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N STATION PLZ",
            "address_2": "SUITE 210",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215011",
            "telephone_number": "917-526-0766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN-WEINER",
        "first_name": "STACI",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2010-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "016138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; 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.