Sally Shore Eisenman, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

7952 Issued in NY

Practice address

35 Hilltop Rd
Port Washington, NY 11050-2725

Phone

(516) 944-3538

Fax

(516) 883-9312

NPI assigned

Apr 23, 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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669690582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HILLTOP RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502725",
            "telephone_number": "516-944-3538",
            "fax_number": "516-883-9312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HILLTOP RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502725",
            "telephone_number": "516-944-3538",
            "fax_number": "516-883-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENMAN",
        "first_name": "SALLY",
        "middle_name": "SHORE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "7952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Kathleen Dumas, MHC-LP
• Anne M Dunne, RN
• Marie T Eagan, D.C.
• Pegah Ebrahim-Hakkak, RPH
• Paul A. Eisen, D.M.D.
• Elder Home Care LLC
• Elizabeth Engelman PHD Psychologist PC
• Kyle Eng, DPT
• Harriet Englander, M.S.
• Epstein Psychology Services PLLC

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

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.