Active NPI
JS Geriatric Psychological Services P.C.
- Psychologist
- Forest Hills, NY
National Provider Identifier
1780005413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2881-057
- Legal business name
- JS GERIATRIC PSYCHOLOGICAL SERVICES P.C.
- Practice address
- 11835 Queens Blvd
Suite 1403
Forest Hills, NY 11375-7200 - Phone
- (718) 268-6600
- Fax
- (718) 268-6065
- NPI assigned
- Dec 24, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Jessica Shroeder
- Title
- Psychologist
- Phone
- (718) 268-6600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2881-057 | WI | Primary |
Addresses
Primary practice location
11835 Queens Blvd
Suite 1403
Forest Hills, NY 11375-7200
Mailing address
11835 Queens Blvd
Suite 1403
Forest Hills, NY 11375-7200
Phone (718) 268-6600
National Provider Directory
National Provider DirectoryLocations
11835 Queens Blvd
Ste 1403
Forest Hills, NY 11375
Phone (718) 268-6065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387843200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1387843200000",
"number": "1780005413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11835 QUEENS BLVD",
"address_2": "SUITE 1403",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113757200",
"telephone_number": "718-268-6600",
"fax_number": "718-268-6065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11835 QUEENS BLVD",
"address_2": "SUITE 1403",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113757200",
"telephone_number": "718-268-6600",
"fax_number": "718-268-6065"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JS GERIATRIC PSYCHOLOGICAL SERVICES P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2013-12-24",
"last_updated": "2013-12-24",
"status": "A",
"authorized_official_last_name": "SHROEDER",
"authorized_official_first_name": "JESSICA",
"authorized_official_title_or_position": "PSYCHOLOGIST",
"authorized_official_telephone_number": "718-268-6600",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "WI",
"license": "2881-057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.