NPIMap

Organization Active NPI

Creedmoor Psychiatric Center

  • Psychiatric Hospital
  • Port Washington, NY
National Provider Identifier
1699817577
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
126421 Issued in NY
Legal business name
CREEDMOOR PSYCHIATRIC CENTER
Practice address
31 Roslyn West Shore Rd,
Port Washington, NY 11050
Phone
(516) 883-4757
NPI assigned
Feb 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Alan Diner, M.D.
Title
Medical Director
Phone
(718) 264-4046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 126421 NY Primary

Addresses

Primary practice location

31 Roslyn West Shore Rd,
Port Washington, NY 11050

Mailing address

8045 Winchester Blvd
Queens Village, NY 11427-2193
Phone (718) 464-7500

National Provider Directory

National Provider Directory
Tax ID family
Pilgirm Psychiatric Center Socr 2147 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699817577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8045 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272193",
            "telephone_number": "718-464-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 ROSLYN WEST SHORE RD,",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "11050",
            "telephone_number": "516-883-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEDMOOR PSYCHIATRIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DINER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-264-4046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NY",
            "license": "126421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.