Individual provider Active NPI

Sara Peshdikian

  • Dance Therapist
  • Glendale, NY
National Provider Identifier
1548901010
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dance TherapistTaxonomy code 225600000X
License
002654 Issued in NY
Practice address
7752 79TH St # 1
Glendale, NY 11385-7505
Phone
(347) 920-8459
NPI assigned
Apr 6, 2022
Last updated
Apr 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dance Therapist 225600000X 002654 NY Primary

Addresses

Primary practice location

7752 79TH St # 1
Glendale, NY 11385-7505

Mailing address

7752 79TH St # 1
Glendale, NY 11385-7505

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

State licenses

LicenseStateTypeSpecialty
002654NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1649203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1548901010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7752 79TH ST # 1",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7752 79TH ST # 1",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857505",
            "telephone_number": "347-920-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESHDIKIAN",
        "first_name": "SARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-06",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225600000X",
            "taxonomy_group": "",
            "desc": "Dance Therapist",
            "state": "NY",
            "license": "002654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.