CHRISTOPHER CHRISTODOULOU


Address: 169 Putnam Hl, Stony Brook, NY 11794-0001
Phone: 6316329510

CHRISTOPHER CHRISTODOULOU (NPI# 1184155210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184155210
Entity Type Individual
Full Name CHRISTOPHER CHRISTODOULOU
Credential PHD
Practice Address 169 Putnam Hl
Stony Brook
NY 11794-0001
Mailing Address Po Box 1559
Stony Brook
NY 11790-0989
Practice Telephone 6316329510
Practice Fax Number 6316325870
Mailing Telephone 6314442990
Mailing Fax Number 6314441560
Enumeration Date 2017-03-21
Last Update Date 2017-03-21
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 012708 NY Behavioral Health & Social Service Providers

Office Location

Street Address 169 PUTNAM HL
City STONY BROOK
State NY
Zip Code 11794-0001

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1619506714 Ryan John Kottmeier Physician Assistant 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 2020-04-02
1699302109 Michael Trentalange Student in an Organized Health Care Education/Training Program Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 2020-03-25
1164985156 Lauren Kate Harris Student in an Organized Health Care Education/Training Program Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 2019-04-08
1851851448 Kathy Tin Student in an Organized Health Care Education/Training Program Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 2019-03-21
1174083703 Arham Khan Student in an Organized Health Care Education/Training Program Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 2019-03-20
1396221982 Aman Bhojani Student in an Organized Health Care Education/Training Program Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 2018-07-17
1699265629 Belliny Phaeton Student in an Organized Health Care Education/Training Program Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 2018-05-15
1629568969 Rachel Herold Student in an Organized Health Care Education/Training Program Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 2018-05-11
1598254419 Nora Ann Diraimondo Nurse Practitioner Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 2018-05-07
1386140705 Ryan Christopher Corn Student in an Organized Health Care Education/Training Program Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 2018-04-04
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356785398 Leigh Elkins Charvet Clinical Neuropsychologist Hsc 12, Stony Brook, NY 11794-8121 2013-04-22
1649271396 Thomas Elmer Preston Clinical Neuropsychologist 29 Hargrove Drive, Stony Brook, NY 11790-2328 2005-08-03
1912179128 Sara L Weisenbach Clinical Neuropsychologist 169 Putnam Hall, Stony Brook, NY 11790 2008-03-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1609408046 Nassau Neuropsychological Services, Pllc Clinical Neuropsychologist 386 S Oyster Bay Rd, Hicksville, NY 11801-3509 2020-02-04
1922656875 Kouros Emami Clinical Neuropsychologist 525 East 71st St., 5th Floor, New York, NY 10021 2019-09-03
1720633860 Emily Kurlansik Clinical Neuropsychologist 300 W 55th St Apt 6c, New York, NY 10019-5164 2019-08-06
1174181382 Kayla Whearty Clinical Neuropsychologist 1554 Northern Blvd Ste 204, Manhasset, NY 11030-3054 2019-06-03
1447729595 Beth Krone Clinical Neuropsychologist 6818 Bay Cliff Ter, Brooklyn, NY 11220-5114 2018-11-19
1750860144 Linda Cristina Calderon Clinical Neuropsychologist 635 W 165th St Rm 633a, New York, NY 10032-3724 2018-08-07
1366936585 Nicole Feirsen Clinical Neuropsychologist 3307 Bainbridge Ave Fl 1, Bronx, NY 10467-2850 2018-06-20
1306349493 Abhishek Jaywant Clinical Neuropsychologist 525 E 68th St # F-1699g, New York, NY 10065-4870 2018-03-14
1043718505 Elsa Lee Clinical Neuropsychologist 25418 Northern Blvd Ste 3, Little Neck, NY 11362-1451 2018-01-30
1154829000 Alice Brown Brandwein Clinical Neuropsychologist 445 Park Ave Fl 2, New York, NY 10022-8649 2018-01-25
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Competitor

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City STONY BROOK
Zip Code 11794

Improve Information

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Dataset Information

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.

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