SIDNEY MALLENBAUM (NPI# 1588734172) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1588734172 |
Entity Type | Individual |
Full Name | SIDNEY MALLENBAUM |
Credential | MD |
Practice Address |
3 Riverside Cir Roanoke VA 24016-4955 |
Practice Telephone | 5402245170 |
Mailing Telephone | 5402245170 |
Enumeration Date | 2006-11-09 |
Last Update Date | 2019-11-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
0101045430 | VA | Allopathic & Osteopathic Physicians |
N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
ME137451 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 1011645-00 | 05 |
Street Address |
3 RIVERSIDE CIR |
City | ROANOKE |
State | VA |
Zip Code | 24016-4955 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376535872 | Bruce E Johnson | Internal Medicine | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2005-08-19 |
1194355024 | Leanna M Stone | Social Worker | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2020-01-20 |
1689231847 | Ashley Light | Audiologist | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2019-05-23 |
1063975282 | Katherine Elizabeth Chafin | Nurse Practitioner | 3 Riverside Cir, Roanoke, VA 24016 | 2019-04-14 |
1932665544 | Amy Marshall | Nurse Practitioner | 3 Riverside Cir, Roanoke, VA 24016 | 2019-02-19 |
1730652991 | Sydney Elizabeth Garst | Physician Assistant | 3 Riverside Cir, Roanoke, VA 24016 | 2019-01-09 |
1306318084 | Sarah Abey | Nurse Practitioner | 3 Riverside Cir, Roanoke, VA 24016 | 2018-12-19 |
1518439397 | Justin James Gray | Clinical Neuropsychologist | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2018-12-18 |
1992281877 | Corinne O'shaughnessy | Audiologist | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2018-07-13 |
1518453463 | Feryal Nauman | Student in an Organized Health Care Education/Training Program | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2018-07-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134758329 | Davis Andrew Sugar | Student in an Organized Health Care Education/Training Program | 1 Riverside Circle, Suite 401, Roanoke, Va, 24016, Suite 401, Roanoke, VA 24016 | 2020-04-08 |
1356810659 | Susanne Tribble | Social Worker | 202 Wells Ave Nw, Roanoke, VA 24016 | 2018-11-15 |
1801305818 | Rena Lee Daye | Driver | 10 12th St. Sw, Roanoke, VA 24016 | 2017-09-21 |
1053841965 | Christin Elledge Clark | Nurse Practitioner | 1234 Franklin Road, Roanoke, VA 24016 | 2017-06-13 |
1235685884 | Helen Franck | Physical Therapist | 650 North Jefferson Street, Roanoke, VA 24016 | 2016-09-01 |
1457710238 | Frances Marie Gaeta | Social Worker | 360 Campbell Ave, Roanoke, VA 24016 | 2016-02-22 |
1982073292 | Sophie Mench Tranmer | Physical Therapist | 1421 Third St. Sw, Roanoke, VA 24016 | 2015-09-16 |
1982008181 | National Counseling Group, Inc | Psychiatry & Neurology | 20 Walnut Avenue, Roanoke, VA 24016 | 2014-10-17 |
1366858342 | National Counseling Group, Inc | Psychiatry & Neurology | 16 Walnut Avenue, Roanoke, VA 24016 | 2014-07-10 |
1427320878 | Kristen L. Jagger | Physical Medicine & Rehabilitation | 1015 First Street Sw Suite 2, Roanoke, VA 24016 | 2012-02-01 |
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Taxonomy Code | 2084N0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology |
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952325102 | Donald B Nolan | Psychiatry & Neurology | 3574 Peakwood Dr Sw, Roanoke, VA 24014-3109 | 2006-07-27 |
1043262553 | John Gordon Burch | Psychiatry & Neurology | 4431 Starkey Rd, Roanoke, VA 24018-0612 | 2006-05-16 |
1619268554 | Chinekwu Ozioma Anyanwu | Psychiatry & Neurology | 3 Riverside Cir, Dept of Neurology, Roanoke, VA 24016-4955 | 2011-04-26 |
1306135744 | J Gordon Burch Md Pllc | Psychiatry & Neurology | 4461 Starkey Rd, Suite 101, Roanoke, VA 24018-0620 | 2011-04-06 |
1700949484 | Della Christine Williams | Psychiatry & Neurology | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2006-12-18 |
1407946981 | James Schmidley | Psychiatry & Neurology | 3 Riverside Circle, Roanoke, VA 24016 | 2006-10-13 |
1104831767 | Stanley Clifford Schold | Psychiatry & Neurology | 3 Riverside Circle, Roanoke, VA 24016 | 2006-07-30 |
1326085028 | Aashit Kanubhai Shah | Psychiatry & Neurology | 3 Riverside Cir, Roanoke, VA 24016 | 2006-06-01 |
1598717928 | Roanoke Neurological Associates | Psychiatry & Neurology | 4461 Starkey Rd, Suite 101, Roanoke, VA 24018-0620 | 2006-05-16 |
1407808843 | William Tingler II | Psychiatry & Neurology | 3 Riverside Cir, Roanoke, VA 24016-4955 | 2006-05-16 |
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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.