Individual provider Active NPI

Lynda B Paull, PHD

  • Clinical Psychologist
  • Bronx, NY
National Provider Identifier
1619037801
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
007380 Issued in NY
Practice address
3736 Henry Hudson Parkway
Suite 206
Bronx, NY 10463
Phone
(718) 543-8907
Fax
(718) 543-8907
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 007380 NY Primary

Addresses

Primary practice location

3736 Henry Hudson Parkway
Suite 206
Bronx, NY 10463

Mailing address

3736 Henry Hudson Parkway
Suite 206
Bronx, NY 10463-1502
Phone (718) 543-8907

Other identifiers 1

IdentifierTypeStateIssuer
147251OtherNYVALUE OPTIONS

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
007380NYMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619037801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3736 HENRY HUDSON PARKWAY",
            "address_2": "SUITE 206",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631502",
            "telephone_number": "718-543-8907",
            "fax_number": "718-543-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3736 HENRY HUDSON PARKWAY",
            "address_2": "SUITE 206",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10463",
            "telephone_number": "718-543-8907",
            "fax_number": "718-543-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULL",
        "first_name": "LYNDA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "007380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "147251",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, 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.

Verify at the official NPI Registry.