Individual provider Active NPI

Jeffrey Jay Mermelstein, PHD

  • Clinical Psychologist
  • Binghamton, NY
National Provider Identifier
1851453682
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
006830 Issued in NY
Practice address
46 Riverside Drive
Binghamton, NY 13905-4511
Phone
(607) 772-1766
Fax
(607) 772-2091
NPI assigned
Dec 15, 2006
Sex
Male
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 006830 NY Primary

Addresses

Primary practice location

46 Riverside Drive
Binghamton, NY 13905-4511

Mailing address

46 Riverside Drive
Binghamton, NY 13905-4511
Phone (607) 772-1766

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

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851453682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 RIVERSIDE DRIVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054511",
            "telephone_number": "607-772-1766",
            "fax_number": "607-772-2091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 RIVERSIDE DRIVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054511",
            "telephone_number": "607-772-1766",
            "fax_number": "607-772-2091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERMELSTEIN",
        "first_name": "JEFFREY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "006830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, 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.

Verify at the official NPI Registry.