Individual provider Active NPI

Jennifer Bik Ki Tam, PSY D

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1982002010
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
020703 Issued in NY
Practice address
100 Morton Street
Apt 9Ew
New York, NY 10014-7803
Phone
(917) 609-8633
Fax
(646) 638-3862
NPI assigned
Dec 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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 020703 NY Primary

Addresses

Primary practice location

100 Morton Street
Apt 9Ew
New York, NY 10014-7803

Mailing address

100 Morton Street
Apt 9Ew
New York, NY 10014-7803
Phone (917) 609-8633

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

LicenseStateTypeSpecialty
020703NYMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417737600000",
    "number": "1982002010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MORTON STREET",
            "address_2": "APT 9EW",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100147803",
            "telephone_number": "917-609-8633",
            "fax_number": "646-638-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MORTON STREET",
            "address_2": "APT 9EW",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100147803",
            "telephone_number": "917-609-8633",
            "fax_number": "646-638-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAM",
        "first_name": "JENNIFER",
        "middle_name": "BIK KI",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.