Active NPI
Stacie Malner
- Physical Therapist
- Ridgewood, NY
National Provider Identifier
1053637082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 032073-1
- Practice address
- 1666 Hancock St
Ridgewood, NY 11385-4727 - Phone
- (718) 456-7588
- NPI assigned
- Apr 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 032073-1 | NY | Primary |
Addresses
Primary practice location
1666 Hancock St
Ridgewood, NY 11385-4727
Mailing address
1666 Hancock St
Ridgewood, NY 11385-4727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032073-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333065600000",
"number": "1053637082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1666 HANCOCK ST",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113854727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1666 HANCOCK ST",
"city": "RIDGEWOOD",
"state": "NY",
"postal_code": "113854727",
"telephone_number": "718-456-7588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALNER",
"first_name": "STACIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-15",
"last_updated": "2012-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "032073-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.