Active NPI
Marybeth Angilella Dartley, PHD
- Psychologist
- New York, NY
National Provider Identifier
1215238274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 018009-1
- Practice address
- 30 E 20TH St Ste 5RW
New York, NY 10003-1310 - Phone
- (917) 696-7080
- NPI assigned
- Nov 8, 2010
- Last updated
- Dec 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 018009-1 | NY | Primary |
| Counseling Psychologist | 103TC1900X | TE61249834 | WA |
Addresses
Primary practice location
30 E 20TH St Ste 5RW
New York, NY 10003-1310
Mailing address
32 Gramercy Park S
10D
New York, NY 10003-1707
Phone (212) 420-9691
Other practice location 1
928 Broadway Ste 1100
New York, NY 10010-8115
Phone (917) 696-7080
Other names 1
- Dr. Marybeth Angilella
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 |
|---|---|---|---|
| TE61249834 | WA | MD | Counseling Psychologist |
| 018009-1 | NY | MD | Surgical Physician Assistant |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- New York, NY
- NPI 1548174204
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1215238274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 GRAMERCY PARK S",
"address_2": "10D",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100031707",
"telephone_number": "212-420-9691"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 E 20TH ST STE 5RW",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100031310",
"telephone_number": "917-696-7080"
}
],
"practiceLocations": [
{
"address_1": "928 Broadway Ste 1100",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100108115",
"country_code": "US",
"telephone_number": "917-696-7080",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANGILELLA DARTLEY",
"first_name": "MARYBETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-08",
"last_updated": "2021-12-30",
"certification_date": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "018009-1",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "WA",
"license": "TE61249834",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARYBETH",
"last_name": "ANGILELLA",
"prefix": "DR.",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}
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 Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.