Edward Michael Petrosky, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015033-2 Issued in NY

Practice address

6812 Yellowstone Blvd
Aa1
Forest Hills, NY 11375-3268

Phone

(917) 520-4444

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1962504845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14950 20TH AVE",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113573131",
            "telephone_number": "917-520-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 YELLOWSTONE BLVD",
            "address_2": "AA1",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753268",
            "telephone_number": "917-520-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSKY",
        "first_name": "EDWARD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015033-2",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teshana N Persaud
• Anisia Peters
• Andrea Petersen
• Ashish Pethani, LCSW
• Keisha Petitmot
• Sinai Peykarian, DDS
• Lauren Pezzo, MA, LMHC,CASAC
• Rebeca Kim Pham, OD
• Trang Pham, B.S. PSYCHOLOGY
• Philip J. Lopresti D.O., P.C.

• Clinical Psychologist in Forest Hills, NY
• Providers in Forest Hills, 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 Jul 9, 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.