Evelyn Botkin, PHD., Psychologist, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4634 Issued in NY

Legal business name

EVELYN BOTKIN, PHD., PSYCHOLOGIST, PC

Practice address

68 Vineyard Rd
Huntington, NY 11743-2260

Phone

(631) 549-3255

Fax

(631) 549-3218

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Evelyn Betty Botkin, PH.D.

Title

President

Phone

(631) 549-3255

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770612384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 VINEYARD RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432260",
            "telephone_number": "631-549-3255",
            "fax_number": "631-549-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 VINEYARD RD",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432260",
            "telephone_number": "631-549-3255",
            "fax_number": "631-549-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVELYN BOTKIN, PHD., PSYCHOLOGIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOTKIN",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_middle_name": "BETTY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-549-3255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "4634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Huntington, NY
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• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.