Active NPI
Georgia Panagopoulos, PHD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1710497565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 009595
- Practice address
- 530 East 72ND Street
Apt 7B
New York, NY 10021-4844 - Phone
- (212) 628-9039
- NPI assigned
- Oct 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 009595 | NY | Primary |
Addresses
Primary practice location
530 East 72ND Street
Apt 7B
New York, NY 10021-4844
Mailing address
530 E 72ND St Apt 7B
New York, NY 10021-4844
Phone (212) 628-9039
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S09595-0 | Other | NY | WORKERS COMPENSATION AUTHORIZATION NUMBER |
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 |
|---|---|---|---|
| 009595 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507248000000",
"number": "1710497565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 E 72ND ST APT 7B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214844",
"telephone_number": "212-628-9039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 EAST 72ND STREET",
"address_2": "APT 7B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100214844",
"telephone_number": "212-628-9039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANAGOPOULOS",
"first_name": "GEORGIA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-06",
"last_updated": "2017-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "009595",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKERS COMPENSATION AUTHORIZATION NUMBER",
"identifier": "S09595-0",
"state": "NY"
}
],
"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 Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.