Active NPI
Marya Gwadz, PH.D.
- Psychologist
- New York, NY
National Provider Identifier
1114259405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 014551
- Practice address
- 200 W 15TH St
First Floor
New York, NY 10011-6539 - Phone
- (917) 863-2125
- NPI assigned
- Feb 11, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 014551 | NY | Primary |
Addresses
Primary practice location
200 W 15TH St
First Floor
New York, NY 10011-6539
Mailing address
503 50TH Ave
Apt 2D
Long Island City, NY 11101-5707
Phone (917) 863-2125
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 |
|---|---|---|---|
| 014551 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265846400000",
"number": "1114259405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 50TH AVE",
"address_2": "APT 2D",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111015707",
"telephone_number": "917-863-2125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W 15TH ST",
"address_2": "FIRST FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100116539",
"telephone_number": "917-863-2125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GWADZ",
"first_name": "MARYA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-11",
"last_updated": "2010-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "014551",
"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 Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.