Individual provider Active NPI

Susan R. Blumenson, PHD

  • Psychoanalyst
  • New York, NY
National Provider Identifier
1710037676
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
000009 Issued in NY
Practice address
24 5TH Ave
Ground Floor Suite
New York, NY 10011
Phone
(212) 473-5580
Fax
(212) 614-0746
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 000009 NY Primary

Addresses

Primary practice location

24 5TH Ave
Ground Floor Suite
New York, NY 10011

Mailing address

24 5TH Ave
Ground Floor Suite
New York, NY 10011
Phone (212) 473-5580

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

LicenseStateTypeSpecialty
000009NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710037676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 5TH AVE",
            "address_2": "GROUND FLOOR SUITE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "212-473-5580",
            "fax_number": "212-614-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 5TH AVE",
            "address_2": "GROUND FLOOR SUITE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10011",
            "telephone_number": "212-473-5580",
            "fax_number": "212-614-0746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMENSON",
        "first_name": "SUSAN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "000009",
            "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 8, 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.