Active NPI
Bruce A. Hubbard, PHD
- Psychologist
- New York, NY
National Provider Identifier
1700872371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 011108
- Practice address
- 164 W 80TH St
New York, NY 10024-6301 - Phone
- (212) 878-5564
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 011108 | NY | Primary |
Addresses
Primary practice location
164 W 80TH St
New York, NY 10024-6301
Mailing address
120 Cabrini Blvd
Apt. 126
New York, NY 10033-3438
Phone (212) 787-5564
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011108 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1700872371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 CABRINI BLVD",
"address_2": "APT. 126",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100333438",
"telephone_number": "212-787-5564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "164 W 80TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100246301",
"telephone_number": "212-878-5564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "BRUCE",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "011108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.