Individual provider Active NPI

Comfort Bola Asanbe, PH.D.

  • Psychologist
  • Staten Island, NY
National Provider Identifier
1518139765
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
017583 Issued in NY
Practice address
2800 Victory Blvd
Staten Island, NY 10314-6609
Phone
(718) 982-3780
Fax
(718) 982-4114
NPI assigned
Mar 27, 2008
Last updated
Mar 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 017583 NY Primary

Addresses

Primary practice location

2800 Victory Blvd
Staten Island, NY 10314-6609

Mailing address

2800 Victory Blvd
Staten Island, NY 10314-6609
Phone (718) 982-3780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090422000362 NY Practitioner - Clinical Psychologist 2769551639 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Adult Care Psychology Services, PLLC CurrentSince May 1, 2008 Accepting new patients

Locations

2099 Forest Ave
Staten Island, NY 10303
Phone (718) 370-7439

797 Brighton Ave
Staten Island, NY 10301
Phone (718) 477-6900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1518139765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146609",
            "telephone_number": "718-982-3780",
            "fax_number": "718-982-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 VICTORY BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146609",
            "telephone_number": "718-982-3780",
            "fax_number": "718-982-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASANBE",
        "first_name": "COMFORT",
        "middle_name": "BOLA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "017583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.