NPIMap

Organization Active NPI

Marvin J, Fine

  • Clinical Psychologist
  • Latham, NY
National Provider Identifier
1336337781
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
010014-1 Issued in NY
Legal business name
MARVIN J, FINE
Doing business as
Affiliated Psychological Services
Practice address
623 New Loudon Rd
Latham, NY 12110-4031
Phone
(518) 783-1051
Fax
(518) 783-1051
NPI assigned
Oct 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Dr. Marvin J Fine, PHD
Title
Director
Phone
(518) 783-1051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 010014-1 NY Primary

Addresses

Primary practice location

623 New Loudon Rd
Latham, NY 12110-4031

Mailing address

70 Nott Road
Rexford, NY 12148
Phone (518) 783-1051

Other identifiers 2

IdentifierTypeStateIssuer
01698604MedicaidNY
01587604MedicaidNY

Other names 1

  • Affiliated Psychological Services Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1336337781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 NOTT ROAD",
            "city": "REXFORD",
            "state": "NY",
            "postal_code": "12148",
            "telephone_number": "518-783-1051",
            "fax_number": "518-783-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 NEW LOUDON RD",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121104031",
            "telephone_number": "518-783-1051",
            "fax_number": "518-783-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN J, FINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "FINE",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "518-783-1051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "010014-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01698604",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01587604",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affiliated Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.