Active NPI
Chanan Reifen
- Group Psychotherapy Psychologist
- New York, NY
National Provider Identifier
1720814015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Group Psychotherapy Psychologist
- License
- 6722100A
- Practice address
- 160 W 86TH St
New York, NY 10024-4018 - Phone
- (212) 875-1300
- NPI assigned
- Sep 12, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Group Psychotherapy Psychologist | 103TP2701X | 6722100A | NY | Primary |
Addresses
Primary practice location
160 W 86TH St
New York, NY 10024-4018
Mailing address
80 Metropolitan Ave
Brooklyn, NY 11249-3919
Phone (401) 473-1111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00244335 | Medicaid | NY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6722100A | NY | MD | Group Psychotherapy Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1720814015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 METROPOLITAN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112493919",
"telephone_number": "401-473-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 W 86TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100244018",
"telephone_number": "212-875-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REIFEN",
"first_name": "CHANAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-12",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TP2701X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Group Psychotherapy",
"state": "NY",
"license": "6722100A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00244335",
"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 Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.