Active NPI
Ron Balamuth, PH.D.
- Psychologist
- New York, NY
National Provider Identifier
1104577121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 01057
- Practice address
- 255 W 85TH St Apt 1D
New York, NY 10024-3265 - Phone
- (212) 877-1118
- NPI assigned
- Jan 11, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01057 | NY | Primary |
Addresses
Primary practice location
255 W 85TH St Apt 1D
New York, NY 10024-3265
Mailing address
255 W 85TH St Apt 1D
New York, NY 10024-3265
Phone (212) 877-1118
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01057 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1104577121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W 85TH ST APT 1D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100243265",
"telephone_number": "212-877-1118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 W 85TH ST APT 1D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100243265",
"telephone_number": "212-877-1118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALAMUTH",
"first_name": "RON",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-11",
"last_updated": "2022-01-11",
"certification_date": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "01057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.