Active NPI
Marcia Malis, PT
- Physical Therapist
- Merrick, NY
National Provider Identifier
1174153472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 009716-01
- Practice address
- 1935 Edward LN
Merrick, NY 11566-4922 - Phone
- (516) 378-4574
- NPI assigned
- Jan 25, 2020
- 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 | 009716-01 | NY | Primary |
Addresses
Primary practice location
1935 Edward LN
Merrick, NY 11566-4922
Mailing address
1935 Edward LN
Merrick, NY 11566-4922
Phone (516) 378-4574
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 |
|---|---|---|---|
| 009716-01 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579910400000",
"number": "1174153472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1935 EDWARD LN",
"city": "MERRICK",
"state": "NY",
"postal_code": "115664922",
"telephone_number": "516-378-4574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 EDWARD LN",
"city": "MERRICK",
"state": "NY",
"postal_code": "115664922",
"telephone_number": "516-378-4574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALIS",
"first_name": "MARCIA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-25",
"last_updated": "2020-01-25",
"certification_date": "2020-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "009716-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrick, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.