| Julia Dyckman Andrus Memorial, Inc. | |
|
19 Greenridge Ave White Plains NY 10605-1201 | |
| (914) 949-7680 | |
| (914) 997-7942 |
| Full Name | Julia Dyckman Andrus Memorial, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 19 Greenridge Ave, White Plains, New York |
| Authorized Official Name and Position | Raul T Del Pilar (INTERIM CEO) |
| Authorized Official Contact | 9149653700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Julia Dyckman Andrus Memorial, Inc. 1156 N Broadway Yonkers NY 10701-1108 Ph: (914) 965-3700 | Julia Dyckman Andrus Memorial, Inc. 19 Greenridge Ave White Plains NY 10605-1201 Ph: (914) 949-7680 |
| NPI Number | 1285628552 |
|---|---|
| Provider Enumeration Date | 09/01/2005 |
| Last Update Date | 09/09/2020 |
| Certification Date | 09/09/2020 |
| Medicare PECOS PAC ID | 8426084401 |
|---|---|
| Medicare Enrollment ID | O20050711000916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285628552 | NPI | - | NPPES |
| 00355940 | Medicaid | NY | |
| 10363 | Other | HUDSON HEALTH PLAN ID | |
| 050309000005 | Other | NY | INTEGRA FIDELIS |
| 322149 | Other | AFFINITY ID | |
| 3191813 | Other | NY | GHI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 7257001A (New York) | Primary |
| Provider Name | Elaine G Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346393337 PECOS PAC ID: 2466440359 Enrollment ID: I20040430001047 |
| Provider Name | Claudia G Sturtz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538111844 PECOS PAC ID: 6305868530 Enrollment ID: I20051230000478 |
| Provider Name | Barbara S Torrest |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285686980 PECOS PAC ID: 6103848247 Enrollment ID: I20060103000653 |
| Provider Name | Leani M Spinner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851342018 PECOS PAC ID: 7517964869 Enrollment ID: I20061028000021 |
| Provider Name | Domenica A South |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407807837 PECOS PAC ID: 9133218498 Enrollment ID: I20071210000319 |
| Provider Name | Meaghan D Zerrle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477633030 PECOS PAC ID: 6305985797 Enrollment ID: I20091124000381 |
| Provider Name | Elizabeth Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366689853 PECOS PAC ID: 1759410848 Enrollment ID: I20100528000010 |
| Provider Name | Aiyana E Rivera-rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477881720 PECOS PAC ID: 3173758943 Enrollment ID: I20131101001348 |
| Provider Name | Jill Winner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790959740 PECOS PAC ID: 0941438113 Enrollment ID: I20140115000537 |
| Provider Name | Michael H Schwartz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578765160 PECOS PAC ID: 4880823194 Enrollment ID: I20140208000116 |
| Provider Name | Jodie Lynn Deignan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770614745 PECOS PAC ID: 4789909003 Enrollment ID: I20150209001591 |
| Provider Name | James L Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851621429 PECOS PAC ID: 9830326347 Enrollment ID: I20161003002279 |
| Provider Name | Susan D Weil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265766851 PECOS PAC ID: 8325336373 Enrollment ID: I20161007000424 |
| Provider Name | Sarah E Tubbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558815324 PECOS PAC ID: 4284973868 Enrollment ID: I20190226000937 |
| Provider Name | Abby J Venzor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962792259 PECOS PAC ID: 1153663158 Enrollment ID: I20190423000979 |
| Provider Name | Efrain Torres |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033520374 PECOS PAC ID: 5597096966 Enrollment ID: I20191016001701 |
| Provider Name | Shira L Kafker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063940799 PECOS PAC ID: 9032546882 Enrollment ID: I20200217004743 |
| Provider Name | Max S Cutler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679059067 PECOS PAC ID: 7517394646 Enrollment ID: I20200229000077 |
| Provider Name | Shirley M Capa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689128589 PECOS PAC ID: 0446667372 Enrollment ID: I20210322000531 |
| Provider Name | Ashna Vohra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710382718 PECOS PAC ID: 1557754454 Enrollment ID: I20220216001573 |
| Provider Name | David Thayer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881621597 PECOS PAC ID: 1254232499 Enrollment ID: I20250328000345 |
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