Individual provider Active NPI

Danielle Christina Malkusz-Lewis, PH.D.

  • Clinical Neuropsychologist
  • Merrick, NY
National Provider Identifier
1285328625
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
P121539 Issued in NY
Practice address
2174 Hewlett Ave
Merrick, NY 11566-3606
Phone
(516) 858-2877
NPI assigned
Jun 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X P121539 NY Primary

Addresses

Primary practice location

2174 Hewlett Ave
Merrick, NY 11566-3606

Mailing address

357 N Wyoming Ave
Massapequa, NY 11758-1521
Phone (917) 443-5582

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

LicenseStateTypeSpecialty
P121539NYMDClinical Neuropsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1285328625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 N WYOMING AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117581521",
            "telephone_number": "917-443-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2174 HEWLETT AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115663606",
            "telephone_number": "516-858-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALKUSZ-LEWIS",
        "first_name": "DANIELLE",
        "middle_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NY",
            "license": "P121539",
            "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 Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.