Individual provider Active NPI

Kristina Kuznetsova

  • Psychologist
  • Bayside, NY
National Provider Identifier
1669026159
Registry record updated Nov 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
028088 Issued in NY
Practice address
1 Bay Club Dr Apt 21V
Bayside, NY 11360-2914
Phone
(917) 683-7691
NPI assigned
Aug 1, 2019
Last updated
Nov 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 028088 NY Primary

Addresses

Primary practice location

1 Bay Club Dr Apt 21V
Bayside, NY 11360-2914

Mailing address

1 Bay Club Dr Apt 21V
Bayside, NY 11360-2914
Phone (917) 683-7691

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

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1794009600000",
    "number": "1669026159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAY CLUB DR APT 21V",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602914",
            "telephone_number": "917-683-7691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY CLUB DR APT 21V",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602914",
            "telephone_number": "917-683-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZNETSOVA",
        "first_name": "KRISTINA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-01",
        "last_updated": "2026-11-07",
        "certification_date": "2026-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "028088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2026; 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.