Individual provider Active NPI

Mary Anne Hanley Geskie, PH.D.

  • Clinical Psychologist
  • West Islip, NY
National Provider Identifier
1861485583
Registry record updated Aug 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
008795 Issued in NY
Practice address
500 Montauk Hwy
Suite Z
West Islip, NY 11795-4418
Phone
(631) 422-5952
Fax
(631) 472-1817
NPI assigned
Aug 28, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2010

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 008795 NY
Cognitive & Behavioral Psychologist 103TB0200X 008795 NY
Clinical Psychologist 103TC0700X 008795 NY Primary
Clinical Child & Adolescent Psychologist 103TC2200X 008795 NY
Psychoanalysis Psychologist 103TP0814X 008795 NY
Psychologist 103T00000X 008795 NY

Addresses

Primary practice location

500 Montauk Hwy
Suite Z
West Islip, NY 11795-4418

Mailing address

7 Saltmeadow CT
Bayport, NY 11705-2205
Phone (631) 472-6048

Other identifiers 2

IdentifierTypeStateIssuer
02145393MedicaidNY
0048459OtherNYVALUE OPTIONS ID NUMBER

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": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281657600000",
    "number": "1861485583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SALTMEADOW CT",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117052205",
            "telephone_number": "631-472-6048",
            "fax_number": "631-472-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MONTAUK HWY",
            "address_2": "SUITE Z",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954418",
            "telephone_number": "631-422-5952",
            "fax_number": "631-472-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GESKIE",
        "first_name": "MARY ANNE",
        "middle_name": "HANLEY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-28",
        "last_updated": "2010-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "008795",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "008795",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "008795",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "008795",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "NY",
            "license": "008795",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "008795",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02145393",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS ID NUMBER",
            "identifier": "0048459",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.