Active NPI
Laura Derubeis-Byrne
- Clinical Psychologist
- Astoria, NY
National Provider Identifier
1700420064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- P103209
- Practice address
- 3123 47TH St Apt 2E
Astoria, NY 11103-1614 - Phone
- (610) 308-2908
- NPI assigned
- Oct 30, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | P103209 | NY | Primary |
Addresses
Primary practice location
3123 47TH St Apt 2E
Astoria, NY 11103-1614
Mailing address
3123 47TH St Apt 2E
Astoria, NY 11103-1614
Phone (610) 308-2908
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P103209 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572393600000",
"number": "1700420064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3123 47TH ST APT 2E",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111031614",
"telephone_number": "610-308-2908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3123 47TH ST APT 2E",
"city": "ASTORIA",
"state": "NY",
"postal_code": "111031614",
"telephone_number": "610-308-2908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERUBEIS-BYRNE",
"first_name": "LAURA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-30",
"last_updated": "2019-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "P103209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Astoria, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.