Active NPI
Anna Marie Tedesco, PHD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1609427798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P102337
- Practice address
- 928 Broadway Ste 1105a
New York, NY 10010-6008 - Phone
- (914) 310-4988
- NPI assigned
- Sep 20, 2019
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P102337 | NY | Primary |
Addresses
Primary practice location
928 Broadway Ste 1105a
New York, NY 10010-6008
Mailing address
25 Caruso PL
Armonk, NY 10504-1366
Phone (914) 310-4988
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P102337 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1609427798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 CARUSO PL",
"city": "ARMONK",
"state": "NY",
"postal_code": "105041366",
"telephone_number": "914-310-4988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 BROADWAY STE 1105A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100106008",
"telephone_number": "914-310-4988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDESCO",
"first_name": "ANNA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-20",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "P102337",
"primary": true
}
],
"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 Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.