Organization Active NPI

JS Geriatric Psychological Services P.C.

  • Psychologist
  • Forest Hills, NY
National Provider Identifier
1780005413
Registry record updated Dec 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2881-057 Issued in WI
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

Updated by the provider on Dec 24, 2013

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)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.