Active NPI
Marvin Daniel Nienaltow, M.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1164629143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 150980
- Practice address
- 11 Riverside Dr
2A-W
New York, NY 10023-2504 - Phone
- (212) 721-7574
- Fax
- (914) 591-0074
- NPI assigned
- Jul 2, 2007
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 150980 | NY | Primary |
Addresses
Primary practice location
11 Riverside Dr
2A-W
New York, NY 10023-2504
Mailing address
11 Riverside Dr
2A-W
New York, NY 10023-2504
Phone (212) 721-7574
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150980 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164629143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 RIVERSIDE DR",
"address_2": "2A-W",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100232504",
"telephone_number": "212-721-7574",
"fax_number": "914-591-0074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 RIVERSIDE DR",
"address_2": "2A-W",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100232504",
"telephone_number": "212-721-7574",
"fax_number": "914-591-0074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIENALTOW",
"first_name": "MARVIN",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "150980",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.