Active NPI
Kevin Christopher Eagan, PSYCHOLOGIST
- Psychologist
- Olean, NY
National Provider Identifier
1912003104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 015401
- Practice address
- 1010 Wayne Street
Suite 100
Olean, NY 14760 - Phone
- (716) 372-3550
- Fax
- (716) 372-3575
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 015401 | NY | Primary |
Addresses
Primary practice location
1010 Wayne Street
Suite 100
Olean, NY 14760
Mailing address
2416 Constitution Ave
Rehabilitation Today Services
Olean, NY 14760
Phone (716) 372-3550
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015401 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabilitation Today Services for Psychology Et Al PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rehabilitation Today Services
- Multi-Specialty Clinic/Center
- Olean, NY
- NPI 1396842811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912003104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2416 CONSTITUTION AVE",
"address_2": "REHABILITATION TODAY SERVICES",
"city": "OLEAN",
"state": "NY",
"postal_code": "14760",
"telephone_number": "716-372-3550",
"fax_number": "716-372-3575"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 WAYNE STREET",
"address_2": "SUITE 100",
"city": "OLEAN",
"state": "NY",
"postal_code": "14760",
"telephone_number": "716-372-3550",
"fax_number": "716-372-3575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGAN",
"first_name": "KEVIN",
"middle_name": "CHRISTOPHER",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "015401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olean, 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.