Active NPI
Erica Rosenberg
- Psychologist
- Roosevelt, NY
National Provider Identifier
1578635413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 012471
- Practice address
- 380 Washington Ave
Roosevelt, NY 11575-1845 - Phone
- (516) 378-2000
- NPI assigned
- Nov 15, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 012471 | NY | Primary |
Addresses
Primary practice location
380 Washington Ave
Roosevelt, NY 11575-1845
Mailing address
15 Wheatley Rd
Glen Head, NY 11545-2905
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00012471 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 012471 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578635413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 WHEATLEY RD",
"city": "GLEN HEAD",
"state": "NY",
"postal_code": "115452905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 WASHINGTON AVE",
"city": "ROOSEVELT",
"state": "NY",
"postal_code": "115751845",
"telephone_number": "516-378-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSENBERG",
"first_name": "ERICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "012471",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00012471",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roosevelt, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.