DR. SUANNE GARBER MALLENBAUM (NPI# 1295757177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295757177 |
| Entity Type | Individual |
| Full Name | DR. SUANNE GARBER MALLENBAUM |
| Credential | MD, PHD |
| Practice Address |
1 West Ave Suite 215 Larchmont NY 10538-2470 |
| Mailing Address |
Po Box 318h Scarsdale NY 10583-8818 |
| Practice Telephone | 9148344379 |
| Practice Fax Number | 9143812633 |
| Mailing Telephone | 9143826308 |
| Mailing Fax Number | 9143816308 |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2084P0005X |
Psychiatry & Neurology Specialization: Neurodevelopmental Disabilities |
183699 | NY | Allopathic & Osteopathic Physicians |
| X | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
183699 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
1 WEST AVE SUITE 215 |
| City | LARCHMONT |
| State | NY |
| Zip Code | 10538-2470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154503233 | Daniela Balint | Community/Behavioral Health | 1 West Ave, Larchmont, NY 10538-2470 | 2007-11-30 |
| 1528125424 | Erica Fross | Social Worker | 1 West Ave, Suite #215, Larchmont, NY 10538-2470 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225497126 | Crystal Michelle Cascio | Dietitian, Registered | 172 Myrtle Blvd Apt 1b, Larchmont, NY 10538 | 2016-02-19 |
| 1487097937 | Christina Erin Wallace | Acupuncturist | 132 Chatsworth Ave Apt 3a, Larchmont, NY 10538 | 2013-04-15 |
| 1033460290 | Jessica Ng | Pharmacist | 1333 Boston Post Road, Larchmont, NY 10538 | 2012-09-27 |
| 1457601908 | Naghmeh Moussapour | Licensed Practical Nurse | 126 C. Larchmot Aecers West, Larchmount, NY 10538 | 2012-09-12 |
| 1790030880 | Bernisse J Flores | Early Intervention Provider Agency | 411 Larchmont Acres, Apt A, Larchmont, NY 10538 | 2012-07-16 |
| 1073878732 | Susan Eienstein Kerz | Specialist | 17 North Brook Road, Larchmont, NY 10538 | 2012-07-09 |
| 1851653869 | Early Achievers | Early Intervention Provider Agency | 29 Pine Ridge Road, Larchmont, NY 10538 | 2012-06-14 |
| 1902166994 | Pietro Dalba Sr. | Internal Medicine | 3 Garit Lane, Larchmont, NY 10538 | 2012-05-23 |
| 1295008852 | Emil Edward Maffucci | Obstetrics & Gynecology | 24 Dimitri Place, Larchmont, NY 10538 | 2012-02-13 |
| 1295007623 | Noelle Elia, Lcsw PC | Social Worker | 4 Chatsworth Avenue, Larchmont, NY 10538 | 2012-02-01 |
| Find all providers in zip 10538 | ||||
| Taxonomy Code | 2084P0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician or neurologist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system such as cerebral palsy, mental retardation and chronic behavioral syndromes, or neurologic conditions. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Psychiatry and Neurology, 2007. http://www.abpn.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Psychiatry and Neurology. A subspecialty certificate for NDN was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Ongoing early discussions regarding proposal. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376630442 | P. Anne Mcbride | Psychiatry & Neurology | 525 E 68th St # 140, New York, NY 10065-4870 | 2006-10-09 |
| 1861434946 | Gerardo Tolentino | Psychiatry & Neurology | 5 Medical Dr, Port Jefferson Station, NY 11776-1595 | 2006-06-12 |
| 1376584102 | Joseph Gartner | Psychiatry & Neurology | 37 Research Way, East Setauket, NY 11733-3465 | 2006-06-10 |
| 1508077512 | Laura Whitman | Psychiatry & Neurology | 310 W 72nd St, 3a, New York, NY 10023-2675 | 2007-05-24 |
| 1659313617 | John C Pomeroy | Psychiatry & Neurology | 5 Medical Dr, Port Jefferson Station, NY 11776-1595 | 2006-06-12 |
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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.