Active NPI
Stanley Rustin, PH.D.
- Psychologist
- Forest Hills, NY
National Provider Identifier
1811046196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 004097
- Practice address
- 10470 Queens Blvd
Suite 200
Forest Hills, NY 11375-3694 - Phone
- (718) 275-6010
- Fax
- (718) 275-6062
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 004097 | NY | Primary |
Addresses
Primary practice location
10470 Queens Blvd
Suite 200
Forest Hills, NY 11375-3694
Mailing address
10470 Queens Blvd
Suite 200
Forest Hills, NY 11375-3694
Phone (718) 275-6010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004097 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811046196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10470 QUEENS BLVD",
"address_2": "SUITE 200",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113753694",
"telephone_number": "718-275-6010",
"fax_number": "718-275-6062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10470 QUEENS BLVD",
"address_2": "SUITE 200",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113753694",
"telephone_number": "718-275-6010",
"fax_number": "718-275-6062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSTIN",
"first_name": "STANLEY",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "004097",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.