Gabriella Nissan, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

025770 Issued in NY

Practice address

184 E 70TH St Ste 5
New York, NY 10021-5154

Phone

(646) 580-5845

NPI assigned

Sep 13, 2021

Last updated

Nov 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1629747613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 E 69TH ST APT 3M",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100210022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 E 70TH ST STE 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100215154",
            "telephone_number": "646-580-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISSAN",
        "first_name": "GABRIELLA",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-13",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "35SI00724100",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "025770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ava Tamiko Nishita-Hawkinson, LMSW
• Emmanuel Nisimov, M.D.
• Tatyana Nisimova
• Noora Johanna Niskanen, LCSW
• Barton Nisonson, MD
• Noam Nissan
• Atara Nissel, PA
• Shira Nissel, O.D
• Michael Nissen, M.D.
• Julie A Nissim, D.O

• Psychologist in New York, NY
• Providers in New York, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.