Nicole Altstatt, PSY. D

Primary specialty

Health PsychologistTaxonomy code 103TH0004X

License

018896 Issued in NY

Practice address

1111 Route 25a
Stony Brook, NY 11790-1907

Phone

(631) 988-1900

NPI assigned

Apr 1, 2013

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 1, 2013.

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364774400000",
    "number": "1982947693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 ROUTE 25A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901907",
            "telephone_number": "631-988-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 ROUTE 25A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901907",
            "telephone_number": "631-988-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTSTATT",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSY. D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NY",
            "license": "018896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Chayanne Almanzar, PA-C
• Mary Ann Armas Almonte, NP-C
• Sean Daniel Altemose
• Dominic John Altieri, MD
• Sibel Altinbas, MD
• Emaan Alvi, MD
• Sean Alyeshmerni
• Colton Barry Amaral, MD
• Clarisa Amarillas Gastelum, DDS,MS
• Ariana Concetta Ambrosio, DO

• All providers in Stony Brook, NY
• Health Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.