Active NPI
Andrea Lauren Camilli, PSY.D.
- Psychologist
- Pleasantville, NY
National Provider Identifier
1821229964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 019324
- Practice address
- 75 Cooley St
Suite 4
Pleasantville, NY 10570-2933 - Phone
- (914) 714-4653
- NPI assigned
- Aug 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 019324 | NY | Primary |
Addresses
Primary practice location
75 Cooley St
Suite 4
Pleasantville, NY 10570-2933
Mailing address
75 Cooley St
Suite 4
Pleasantville, NY 10570-2933
Phone (914) 714-4653
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019324 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320451200000",
"number": "1821229964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 COOLEY ST",
"address_2": "SUITE 4",
"city": "PLEASANTVILLE",
"state": "NY",
"postal_code": "105702933",
"telephone_number": "914-714-4653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 COOLEY ST",
"address_2": "SUITE 4",
"city": "PLEASANTVILLE",
"state": "NY",
"postal_code": "105702933",
"telephone_number": "914-714-4653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMILLI",
"first_name": "ANDREA",
"middle_name": "LAUREN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-06",
"last_updated": "2011-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "019324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasantville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.