Amy Renee Malkin-Ingoglia, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

016097 Issued in NY

Practice address

800 Poly PL
Vanyhhcs, Brooklyn: Department of Psychology (116B)
Brooklyn, NY 11209-7104

Phone

(718) 836-6600

Fax

(718) 630-2894

NPI assigned

Aug 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 14, 2020 through Aug 14, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1306954623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 E BROADWAY",
            "city": "LONG BEACH",
            "state": "NY",
            "postal_code": "115614534",
            "telephone_number": "516-889-6547",
            "fax_number": "718-630-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PL",
            "address_2": "VANYHHCS, BROOKLYN: DEPARTMENT OF PSYCHOLOGY (116B)",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112097104",
            "telephone_number": "718-836-6600",
            "fax_number": "718-630-2894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Village Ave Ste 36",
            "address_purpose": "LOCATION",
            "city": "Rockville Centre",
            "state": "NY",
            "postal_code": "115703712",
            "country_code": "US",
            "telephone_number": "516-567-6927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALKIN-INGOGLIA",
        "first_name": "AMY",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulina Malinowska, LMHC
• Sarah Malis, LMSW
• Kassandra Malivert
• Malka Nussbaum Licensed Behavioral Analyst, PLLC
• Menachem Mendel Malka
• Larry Malkin, DO
• Spencer Jason Malkin, DC
• Zoe Malkin, LCSW
• Genrietta Malkinzon, MD
• Megan Malko, MA, CF-SLP

• Clinical Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.