Active NPI
Marisa Anne Imhof
- Specialist
- Purchase, NY
National Provider Identifier
1316472574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1082587161
- Practice address
- 2700 Westchester Ave
Suite 300
Purchase, NY 10577-2547 - Phone
- (914) 564-6879
- NPI assigned
- Apr 25, 2017
- Last updated
- Oct 17, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1082587161 | NY | Primary |
Addresses
Primary practice location
2700 Westchester Ave
Suite 300
Purchase, NY 10577-2547
Mailing address
2700 Westchester Ave
Suite 300
Purchase, NY 10577-2547
Phone (914) 564-6879
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 |
|---|---|---|---|
| 1082587161 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539734400000",
"number": "1316472574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2700 WESTCHESTER AVE",
"address_2": "SUITE 300",
"city": "PURCHASE",
"state": "NY",
"postal_code": "105772547",
"telephone_number": "914-564-6879"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 WESTCHESTER AVE",
"address_2": "SUITE 300",
"city": "PURCHASE",
"state": "NY",
"postal_code": "105772547",
"telephone_number": "914-564-6879"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMHOF",
"first_name": "MARISA",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-25",
"last_updated": "2018-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "1082587161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Purchase, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.