Alice A Medalia, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

007362 Issued in NY

Practice address

MMC - Dept. of Psychiatry
111 East 210TH Street, Klau 2
Bronx, NY 10467

Phone

(718) 920-7311

NPI assigned

Nov 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Montefiore Medical Center

  dba Montefiore Community Pharmacy @ CHAM

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316017528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CLUBWAY",
            "city": "HARTSDALE",
            "state": "NY",
            "postal_code": "105303615",
            "telephone_number": "718-920-7311",
            "fax_number": "718-405-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MMC - DEPT. OF PSYCHIATRY",
            "address_2": "111 EAST 210TH STREET, KLAU 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10467",
            "telephone_number": "718-920-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDALIA",
        "first_name": "ALICE",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "007362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med Plus Services, Inc.
• Med Star Surgical & Breathing Equipment Inc. (AdaptHealth NY)
• Med Star Surgical & Breathing Equipment, Inc. (AdaptHealth NY)
• Med Sync Supply Corp (MedSync Supply)
• Med-Care Prosthesis & Medical Supplies
• Joyce Medalla, PT
• Medalliance Medical Health Services
• Medalliance Medical Health Services
• Medalliance Medical Health Services
• Medalliance Medical Health Services Inc

• Psychologist in Bronx, NY
• Providers in Bronx, NY by specialty
• Psychologist in New York

• 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.

Verify at the official NPI Registry.