Active NPI
Samantha-Jean Bagwandeen
- Psychologist
- Arverne, NY
National Provider Identifier
1760239701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1622585221
- Practice address
- 305 Beach 69TH St
Arverne, NY 11692-1426 - Phone
- (347) 323-7511
- NPI assigned
- May 6, 2024
- Last updated
- May 6, 2024
- Sex
- Female
- 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 | 1622585221 | NY | Primary |
Addresses
Primary practice location
305 Beach 69TH St
Arverne, NY 11692-1426
Mailing address
305 Beach 69TH St
Arverne, NY 11692-1426
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 |
|---|---|---|---|
| 1622585221 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714953600000",
"number": "1760239701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 BEACH 69TH ST",
"city": "ARVERNE",
"state": "NY",
"postal_code": "116921426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 BEACH 69TH ST",
"city": "ARVERNE",
"state": "NY",
"postal_code": "116921426",
"telephone_number": "347-323-7511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGWANDEEN",
"first_name": "SAMANTHA-JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-06",
"last_updated": "2024-05-06",
"certification_date": "2024-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "1622585221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arverne, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.