J Robert Quilty PHD Psychologist PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

010801 Issued in NY

Legal business name

J ROBERT QUILTY PHD PSYCHOLOGIST PC

Practice address

139 Main Street
Stony Brook, NY 11790-0304

Phone

(631) 751-4873

Fax

(631) 473-8282

NPI assigned

Dec 18, 2014

Organization subpart

No

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

Authorized official

Name

Robert Quilty, PH.D.NPI 1184608655

Title

Psychologist

Phone

(631) 751-4873

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Quilty, PH.D.

  • Clinical Psychologist
  • Stony Brook, NY
  • NPI 1184608655
  Medicare reassignment NPD Authorized official
• Dorothy A Quilty, L.C.S.W

  • Mental Health Counselor
  • Miller Place, NY
  • NPI 1619949351
  NPD (past)

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1841698131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 304",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900304",
            "telephone_number": "631-751-4873",
            "fax_number": "631-473-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 MAIN STREET",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900304",
            "telephone_number": "631-751-4873",
            "fax_number": "631-473-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J ROBERT QUILTY PHD PSYCHOLOGIST PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "QUILTY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "631-751-4873",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "010801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Island Chiropractic Pain Care
• Island Wide Medical Health Services. PC
• Ahmed Ismail, MD
• Danielle Itshaik
• Igor Izrailtyan, M.D.
• Melissa Jaber
• Raja Jaber, M.D.
• Lori Rita Jabour
• Michelle Jack, PA-C
• Anjali Mareena Jacob

• Clinical Psychologist in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.