Individual provider Active NPI

Barbara Ann Russek, PSYD

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1518177567
Registry record updated Jul 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011617 Issued in NY
Practice address
30 E End Ave
1B
New York, NY 10028-7053
Phone
(212) 737-8370
Fax
(212) 737-6416
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 011617 NY
Clinical Psychologist 103TC0700X 011617 NY Primary
Clinical Child & Adolescent Psychologist 103TC2200X 011617 NY
Family Psychologist 103TF0000X 011617 NY

Addresses

Primary practice location

30 E End Ave
1B
New York, NY 10028-7053

Mailing address

30 E End Ave
1B
New York, NY 10028-7053
Phone (212) 737-8370

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1518177567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E END AVE",
            "address_2": "1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287053",
            "telephone_number": "212-737-8370",
            "fax_number": "212-737-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E END AVE",
            "address_2": "1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100287053",
            "telephone_number": "212-737-8370",
            "fax_number": "212-737-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSEK",
        "first_name": "BARBARA",
        "middle_name": "ANN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "011617",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011617",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "011617",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NY",
            "license": "011617",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jul 16, 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.