Organization Active NPI

South Shore Psychological Services PLLC

  • Psychologist
  • Cedarhurst, NY
National Provider Identifier
1770680472
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8501 Issued in NY
Legal business name
SOUTH SHORE PSYCHOLOGICAL SERVICES PLLC
Practice address
144 Grove Ave
Cedarhurst, NY 11516-2315
Phone
(516) 791-0111
Fax
(516) 374-9640
NPI assigned
Sep 17, 2006
Last updated
Jun 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Authorized official

Name
Dr. Sunita Saini, DSW
Title
Manager
Phone
(516) 791-0111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8501 NY Primary

Addresses

Primary practice location

144 Grove Ave
Cedarhurst, NY 11516-2315

Mailing address

144 Grove Ave
Cedarhurst, NY 11516-2315
Phone (516) 791-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040312000455 NY Part B Supplier - Clinic/Group Practice 2365331824 Receives reassigned benefits from 4 practitioners
Practice locations: Cedarhurst, NY; Long Beach, NY

National Provider Directory

National Provider Directory

Locations

135 Franklin Ave
Franklin Square, NY 11010
Phone (516) 358-0994

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435190400000",
    "number": "1770680472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 GROVE AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162315",
            "telephone_number": "516-791-0111",
            "fax_number": "516-374-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 GROVE AVE",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162315",
            "telephone_number": "516-791-0111",
            "fax_number": "516-374-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-06-25",
        "status": "A",
        "authorized_official_last_name": "SAINI",
        "authorized_official_first_name": "SUNITA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-791-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "8501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.