KATHRYN MIRRA PHD
NPI 1720373657
Clinical Neuropsychologist in Manhasset, NY

Q: What is Kathryn Mirra's NPI number?

The NPI number for Kathryn Mirra is 1720373657. It was assigned to this individual provider in the NPPES registry on June 20, 2011.

Q: What is Kathryn Mirra's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Kathryn Mirra was last updated on July 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 20, 2011PECOS Enrolled

1554 NORTHERN BLVD FL 3, MANHASSET, NY 11030(516) 719-3700 Get Directions Write a Review

NPPES record last updated: July 27, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kathryn Mirra Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHRYN MIRRA PHD (NPI 1720373657) is an individual clinical neuropsychologist in Manhasset, New York, licensed in New York (020150) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720373657

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameKATHRYN MIRRACredential: PHD

Location Address1554 NORTHERN BLVD FL 3Manhasset, NY 11030-3054

Mailing Address1554 Northern Blvd Fl 3Manhasset, NY 11030-3054 · (516) 719-3799

Phone(516) 719-3700

Sole ProprietorNo

Enumeration DateJune 20, 2011

Last NPPES UpdateJuly 27, 2023

NPPES CertifiedJuly 27, 2023

✔ NPI 1720373657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in NY · 020150

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

1554 NORTHERN BLVD FL 3, Manhasset, NY 11030

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kathryn Mirra Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAITLIN M AIREY

Physical Therapist