DR. PETER VIETZE (NPI# 1235266016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235266016 |
| Entity Type | Individual |
| Full Name | DR. PETER VIETZE |
| Credential | PH.D. |
| Practice Address |
465 Grand St 3rd Floor New York NY 10002-4800 |
| Mailing Address |
957 Cedarbrook Rd Plainfield NJ 07060-2646 |
| Practice Telephone | 3476684992 |
| Practice Fax Number | 2124201910 |
| Mailing Telephone | 3476684992 |
| Mailing Fax Number | 9087578322 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2015-04-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
017065 | NY | Behavioral Health & Social Service Providers |
| Street Address |
465 GRAND ST 3RD FLOOR |
| City | NEW YORK |
| State | NY |
| Zip Code | 10002-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309415 | Nicole Cybil Sook Yi Lim | Psychologist | 465 Grand St, New York, NY 10002-4800 | 2020-09-01 |
| 1265046890 | Alma Coral Torres Colon | Clinic/Center | 465 Grand St, New York, NY 10002-4800 | 2020-09-01 |
| 1982225066 | Leah Pollak | Social Worker | 465 Grand St, New York, NY 10002-4800 | 2020-04-30 |
| 1801417985 | Sarah Rieder | Social Worker | 465 Grand St, New York, NY 10002-4800 | 2020-04-30 |
| 1902427081 | Leah Roman | Social Worker | 465 Grand St, New York, NY 10002-4800 | 2020-04-30 |
| 1376182865 | Madelyn Buestan | Social Worker | 465 Grand St, New York, NY 10002-4800 | 2019-12-31 |
| 1225687379 | Samara Lipsky | Psychologist | 465 Grand St, New York, NY 10002-4800 | 2019-09-10 |
| 1932756665 | Eudis D Wynns | Specialist | 465 Grand St, New York, NY 10002-4800 | 2019-08-19 |
| 1497317101 | Qianhong Lin | Case Manager/Care Coordinator | 465 Grand St, New York, NY 10002-4800 | 2019-07-02 |
| 1639735012 | Dmitriy Yesin | Behavioral Analyst | 465 Grand St, New York, NY 10002-4800 | 2019-05-12 |
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| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
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|---|---|---|---|---|
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| 1447648753 | Victoria I Phillips | Psychologist | 10 W 65th St Apt 5d, New York, NY 10023-6639 | 2015-01-08 |
| 1588006050 | Joselyn Fine | Psychologist | 740 W End Ave Apt 5, New York, NY 10025-6256 | 2013-07-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.