Individual provider Active NPI

Lucy Waletzky, M.D.

  • Psychiatry Physician
  • Sleepy Hollow, NY
National Provider Identifier
1508926163
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
104021-1 Issued in NY
Practice address
239 N Broadway
Suite 6
Sleepy Hollow, NY 10591-2674
Phone
(914) 366-6100
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 104021-1 NY Primary

Addresses

Primary practice location

239 N Broadway
Suite 6
Sleepy Hollow, NY 10591-2674

Mailing address

239 N Broadway
Suite 6
Sleepy Hollow, NY 10591-2674
Phone (914) 366-6100

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
104021-1NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Sloan Kettering Cancer Center PastSince May 31, 2007 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1508926163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 N BROADWAY",
            "address_2": "SUITE 6",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912674",
            "telephone_number": "914-366-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 N BROADWAY",
            "address_2": "SUITE 6",
            "city": "SLEEPY HOLLOW",
            "state": "NY",
            "postal_code": "105912674",
            "telephone_number": "914-366-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALETZKY",
        "first_name": "LUCY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "104021-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sleepy Hollow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.