Jodie Marie Ambrosino, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

002646 Issued in CT

Practice address

2 Church St S
Suite 404
New Haven, CT 06519-1717

Phone

(203) 785-5282

Fax

(203) 764-6748

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Yale University

  • Clinic/Center
  • New Haven, CT
  • NPI 1497922231
  NPD (past)

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1669670915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST S",
            "address_2": "SUITE 404",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-785-5282",
            "fax_number": "203-764-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHURCH ST S",
            "address_2": "SUITE 404",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191717",
            "telephone_number": "203-785-5282",
            "fax_number": "203-764-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSINO",
        "first_name": "JODIE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CT",
            "license": "002646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Edward Amato Sr., MD
• Megan Jane Amaturo, LCSW
• Sebastian Amaya, MD
• Jodi Ambler
• Alexander Ambrosini
• Nicola Amell
• Shelley L. Amen, M.D., PH.D.
• Emily Amento, R.R.A., R.T. (R)
• Derrick Amenyedor
• Kelvin Eyram Amenyedor, MD

• All providers in New Haven, CT
• Clinical Child & Adolescent Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.