Individual provider Active NPI

Christine J. Mihaila, PH.D.

  • Clinical Neuropsychologist
  • New York, NY
National Provider Identifier
1548469604
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
017224 Issued in NY
Practice address
65 Broadway
Ste 842
New York, NY 10006-2503
Phone
(347) 994-8855
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 017224 NY
Clinical Neuropsychologist 103G00000X 017224 NY Primary

Addresses

Primary practice location

65 Broadway
Ste 842
New York, NY 10006-2503

Mailing address

65 Broadway Ste 842
New York, NY 10006-2503
Phone (347) 994-8855

Other practice location 1

1010 Northern Blvd
Suite 130
Great Neck, NY 11021-5317
Phone (347) 994-8855

Other practice location 2

1010 Northern Blvd
Suite 130
Great Neck, NY 11021-5317
Phone (347) 994-8855

Other identifiers 1

IdentifierTypeStateIssuer
03130605MedicaidNY

Other names 1

  • Christine J. Weber Former name

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 Philosophy

State licenses

LicenseStateTypeSpecialty
017224NYMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Brain Specialists, LLC Past Accepting new patients
The Epilepsy Institute PastSince Apr 9, 2024 Accepting new patients
Epilepsy & Neurophysiology Medical Consulting PC Clinical Neuropsychologist PastSince Aug 30, 2009 Accepting new patients

Organizations & group practices 3

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": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1548469604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 BROADWAY STE 842",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062503",
            "telephone_number": "347-994-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 BROADWAY",
            "address_2": "STE 842",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100062503",
            "telephone_number": "347-994-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Northern Blvd",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110215317",
            "country_code": "US",
            "telephone_number": "347-994-8855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 Northern Blvd",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110215317",
            "country_code": "US",
            "telephone_number": "347-994-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIHAILA",
        "first_name": "CHRISTINE",
        "middle_name": "J.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "017224",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "017224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03130605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "WEBER",
            "middle_name": "J.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Mar 17, 2018; 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.