Individual provider Active NPI

Bruce J Marsh, PHD

  • Clinical Psychologist
  • Huntington, NY
National Provider Identifier
1093871675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
009568 Issued in NY
Practice address
205 E Main St
Suite 2-3C
Huntington, NY 11743-2923
Phone
(631) 367-7392
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 009568 NY Primary

Addresses

Primary practice location

205 E Main St
Suite 2-3C
Huntington, NY 11743-2923

Mailing address

205 E Main St
Suite 2-3C
Huntington, NY 11743-2923
Phone (631) 367-7392

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000858 NY Practitioner - Clinical Psychologist 6608034749 Practice locations: Huntington, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

205 E Main St
Suite 2 3C
Huntington, NY 11743-2923
Phone (631) 367-7392

205 E Main St
Suite 2 3C
Huntington, NY 11743-7943

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
009568NYMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093871675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E MAIN ST",
            "address_2": "SUITE 2-3C",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432923",
            "telephone_number": "631-367-7392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E MAIN ST",
            "address_2": "SUITE 2-3C",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117432923",
            "telephone_number": "631-367-7392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "BRUCE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "009568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.