Individual provider Active NPI

Elisa Marlo Liker, PSY D

  • Clinical Psychologist
  • White Plains, NY
National Provider Identifier
1780694828
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016312 Issued in NY
Practice address
3 Barker Avenue
4TH Floor Park Avenue Medical Associates PC
White Plains, NY 10601
Phone
(914) 949-1199
Fax
(914) 949-1245
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 016312 NY Primary

Addresses

Primary practice location

3 Barker Avenue
4TH Floor Park Avenue Medical Associates PC
White Plains, NY 10601

Mailing address

3 Barker Avenue
4TH Floor Park Avenue Medical Associates PC
White Plains, NY 10601
Phone (914) 949-1199

Other identifiers 1

IdentifierTypeStateIssuer
02691101MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050725000733 NY Practitioner - Clinical Psychologist 3678500360 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

135 Vanderbilt Ave
Staten Island, NY 10304-2604
Phone (800) 275-3243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016312NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Apr 30, 2010 Accepting new patients
NYU Langone Hospitals CurrentSince Apr 1, 2005 Accepting new patients
NYU Langone Hospitals CurrentSince Apr 1, 2005 Accepting new patients

Locations

3512 Quentin Rd
Ste 110
Brooklyn, NY 11234
Phone (718) 854-8370

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

301 E 17th St
New York, NY 10003
Phone (212) 460-0125

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 447-0101

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780694828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 BARKER AVENUE",
            "address_2": "4TH FLOOR PARK AVENUE MEDICAL ASSOCIATES PC",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "10601",
            "telephone_number": "914-949-1199",
            "fax_number": "914-949-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BARKER AVENUE",
            "address_2": "4TH FLOOR PARK AVENUE MEDICAL ASSOCIATES PC",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "10601",
            "telephone_number": "914-949-1199",
            "fax_number": "914-949-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIKER",
        "first_name": "ELISA",
        "middle_name": "MARLO",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02691101",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.