NPI Code Detail JSON Logo

1710944780 NPI number — NAOMI ROBIN DRIESEN PHD

NPI Number: 1710944780
Health Care Provider/Practitioner: NAOMI ROBIN DRIESEN PHD

Information about “1710944780” NPI (NAOMI ROBIN DRIESEN PHD) exists in 1710944780 in HTML format HTML  |  1710944780 in plain Text format TXT  |  1710944780 in PDF (Portable Document Format) PDF  |  1710944780 in an XML format XML  formats.

NPI Number : 1710944780 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1710944780",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "X",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DRIESEN",
    "FirstName": "NAOMI",
    "MiddleName": "ROBIN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "300 GEORGE ST",
    "SecondLineMailingAddress": "PO BOX 9805",
    "MailingAddressCityName": "NEW HAVEN",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06511-6624",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "203-785-7998",
    "MailingAddressFaxNumber": "203-785-6414",
    "FirstLinePracticeLocationAddress": "800 HOWARD AVE",
    "SecondLinePracticeLocationAddress": "YALE PHYSICIANS BLDG",
    "PracticeLocationAddressCityName": "NEW HAVEN",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06519-1369",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-785-2140",
    "PracticeLocationAddressFaxNumber": "203-785-6414",
    "EnumerationDate": "04/26/2006",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103TC0700X",
        "TaxonomyName": "Clinical Psychologist",
        "LicenseNumber": "002247",
        "LicenseNumberStateCode": "CT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.