Individual provider Active NPI

Mary Rose Quinn Paster, PH.D.

  • Psychologist
  • Glen Cove, NY
National Provider Identifier
1710101662
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
007073-1 Issued in NY
Practice address
105 Lattingtown Rd
Glen Cove, NY 11542-1200
Phone
(516) 676-8675
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 007073-1 NY Primary

Addresses

Primary practice location

105 Lattingtown Rd
Glen Cove, NY 11542-1200

Mailing address

105 Lattingtown Rd
Glen Cove, NY 11542-1200
Phone (516) 676-8675

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171116000576 NY Practitioner - Clinical Psychologist 1153687611 Practice locations: Glen Cove, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

105 Lattingtown Rd
Glen Cove, NY 11542-1200
Phone (516) 676-8675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
007073-1NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1710101662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 LATTINGTOWN RD",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115421200",
            "telephone_number": "516-676-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 LATTINGTOWN RD",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115421200",
            "telephone_number": "516-676-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTER",
        "first_name": "MARY ROSE",
        "middle_name": "QUINN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "007073-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Cove, NY

Sources for this page

Verify at the official NPI Registry.