Individual provider Active NPI

Ingrid Irene Roze, PH.D.

  • Clinical Psychologist
  • Brooklyn, NY
National Provider Identifier
1659524510
Registry record updated Aug 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009920-10 Issued in NY
Practice address
249 19TH St
4A
Brooklyn, NY 11215-5480
Phone
(718) 499-3054
Fax
(718) 499-3089
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2009

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 009920-10 NY Primary

Addresses

Primary practice location

249 19TH St
4A
Brooklyn, NY 11215-5480

Mailing address

249 19TH St
4A
Brooklyn, NY 11215-5480
Phone (718) 499-3054

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

LicenseStateTypeSpecialty
009920-10NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1659524510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 19TH ST",
            "address_2": "4A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155480",
            "telephone_number": "718-499-3054",
            "fax_number": "718-499-3089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 19TH ST",
            "address_2": "4A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155480",
            "telephone_number": "718-499-3054",
            "fax_number": "718-499-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZE",
        "first_name": "INGRID",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009920-10",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; 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.