Active NPI
Nira Suri Nafisi, PH.D.
- Clinical Psychologist
- Great Neck, NY
National Provider Identifier
1982884276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 017337-1
- Practice address
- 29 Barstow Rd Ste 102
Great Neck, NY 11021-2209 - Phone
- (516) 297-9810
- NPI assigned
- Nov 5, 2007
- 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 | 017337-1 | NY | Primary |
Addresses
Primary practice location
29 Barstow Rd Ste 102
Great Neck, NY 11021-2209
Mailing address
29 Barstow Rd Ste 102
Great Neck, NY 11021-2209
Phone (516) 297-9810
Other names 1
- Dr. Nira Suri Golombeck
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 4, 2021 through Feb 4, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017337-1 | NY | MD | Clinical Psychologist |
| 017337 | NY | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216252800000",
"number": "1982884276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 BARSTOW RD STE 102",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212209",
"telephone_number": "516-297-9810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BARSTOW RD STE 102",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110212209",
"telephone_number": "516-297-9810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAFISI",
"first_name": "NIRA",
"middle_name": "SURI",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-05",
"last_updated": "2008-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "017337-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NIRA",
"last_name": "GOLOMBECK",
"middle_name": "SURI",
"prefix": "DR.",
"credential": "PH.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.