Tricia L Park, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015109-1 Issued in NY

Practice address

202 E Main St
Endicott, NY 13760-4817

Phone

(607) 754-2660

Fax

(607) 754-2660

NPI assigned

Jun 26, 2006

Last updated

Nov 4, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Hospitalist Healthcare Services PLLC

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1275962011
  Medicare reassignment NPD
• Hospitalist Healthcare Services PLLC

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1902224520

  Clinical

  NPD
• Enhanced Medical Care PC

  • Legal Medicine
  • Liberty, NY
  • NPI 1699063073
  NPD (past)
• Professional Practice Group, Dept. of Psych

  • Clinical Social Worker
  • Syracuse, NY
  • NPI 1710929047
  NPD (past)
• Samaritan Counseling Center of the Southern Tier Inc

  • Mental Health Counselor
  • Endicott, NY
  • NPI 1467520080
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1548297724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604817",
            "telephone_number": "607-754-2660",
            "fax_number": "607-754-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E MAIN ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137604817",
            "telephone_number": "607-754-2660",
            "fax_number": "607-754-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "TRICIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015109-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Ondrusek, MD
• Elizabeth Orzel
• Deborah J. Owen, R.D., C.D.N.
• Palmer Industries, Inc.
• Jamie Dee Papathomopoulos, LMSW
• Marie Lisa Pascucci
• Antilkumar Patel, M.D
• Pecora Ophthalmology Practice PLLC (Eye Sight Associates)
• J Louis Pecora, MD
• Lawrence J Pecora, MD

• Clinical Psychologist in Endicott, NY
• Providers in Endicott, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.