Active NPI
Kathleen Mary Anesko, PH.D.
- Clinical Psychologist
- River Vale, NJ
National Provider Identifier
1891948956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 009978-1
- Practice address
- 619 Maple St
Rivervale, NJ 07675-6549 - Phone
- (201) 930-0435
- Fax
- (201) 930-0435
- NPI assigned
- Nov 2, 2008
- Last updated
- Nov 2, 2008
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 009978-1 | NY | Primary |
Addresses
Primary practice location
619 Maple St
Rivervale, NJ 07675-6549
Mailing address
619 Maple St
Rivervale, NJ 07675-6549
Phone (201) 930-0435
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009978-1 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225584000000",
"number": "1891948956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 MAPLE ST",
"city": "RIVERVALE",
"state": "NJ",
"postal_code": "076756549",
"telephone_number": "201-930-0435",
"fax_number": "201-930-0435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 MAPLE ST",
"city": "RIVERVALE",
"state": "NJ",
"postal_code": "076756549",
"telephone_number": "201-930-0435",
"fax_number": "201-930-0435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANESKO",
"first_name": "KATHLEEN",
"middle_name": "MARY",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-02",
"last_updated": "2008-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "009978-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in River Vale, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.