Individual provider Active NPI

Emily D'Antonio, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1992135123
Registry record updated Nov 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
68020088 Issued in NY
Practice address
777 W End Ave
Suite 1B
New York, NY 10025-5551
Phone
(917) 664-6418
NPI assigned
Nov 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2013

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 68020088 NY Primary

Addresses

Primary practice location

777 W End Ave
Suite 1B
New York, NY 10025-5551

Mailing address

777 W End Ave
Suite 1B
New York, NY 10025-5551
Phone (917) 664-6418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313002174 NY Practitioner - Clinical Psychologist 9739429515 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
68020088NYMDClinical Psychologist
020088NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Jan 23, 2019 Accepting new patients
Neurological Specialties of Long Island, PLLC CurrentSince Feb 26, 2019 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jan 23, 2019 Accepting new patients
Medical Services of Kips Bay PC CurrentSince Sep 19, 2023 Accepting new patients
Medical Services of Kips Bay PC CurrentSince Sep 19, 2023 Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

825 Northern Blvd
Ste 201
Great Neck, NY 11021
Phone (516) 396-7846

170 Great Neck Rd
Great Neck, NY 11021
Phone (516) 487-4464

27005 76th Ave
North New Hyde Pk, NY 11040

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1385337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385337600000",
    "number": "1992135123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 W END AVE",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255551",
            "telephone_number": "917-664-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 W END AVE",
            "address_2": "SUITE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255551",
            "telephone_number": "917-664-6418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANTONIO",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-25",
        "last_updated": "2013-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "68020088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.