Individual provider Active NPI

Debora Soler Munczek, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1487775664
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
012914 Issued in NY
Practice address
116 Pinehurst Ave # B23
New York, NY 10033-1755
Phone
(212) 923-6878
Fax
(212) 928-4209
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 012914 NY Primary

Addresses

Primary practice location

116 Pinehurst Ave # B23
New York, NY 10033-1755

Mailing address

116 Pinehurst Ave # B23
New York, NY 10033-1755
Phone (212) 923-6878

Other identifiers 3

IdentifierTypeStateIssuer
02448048MedicaidNY
5435657OtherNYAETNA
P471446OtherNYOXFORD HEALTH PLANS

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1487775664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 PINEHURST AVE # B23",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100331755",
            "telephone_number": "212-923-6878",
            "fax_number": "212-923-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 PINEHURST AVE # B23",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100331755",
            "telephone_number": "212-923-6878",
            "fax_number": "212-928-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNCZEK",
        "first_name": "DEBORA",
        "middle_name": "SOLER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02448048",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5435657",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P471446",
            "state": "NY"
        }
    ],
    "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 Jun 11, 2008; 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.