Active NPI
Mallory Sapoff, PSYD
- Clinical Psychologist
- Lynbrook, NY
National Provider Identifier
1346850625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 023779
- Practice address
- 68 Lloyd Ave
Lynbrook, NY 11563-4045 - Phone
- (516) 244-9960
- NPI assigned
- Aug 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 023779 | NY | Primary |
Addresses
Primary practice location
68 Lloyd Ave
Lynbrook, NY 11563-4045
Mailing address
79 Monroe St Apt 1S
Hoboken, NJ 07030-6527
Phone (516) 244-9960
Other practice location 1
79 Monroe St Apt 1S
Hoboken, NJ 07030-6527
Phone (516) 244-9960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 023779 | Other | NY | NYS PSYCHOLOGIST LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | restorativeinsight.com | Direct |
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 |
|---|---|---|---|
| 023779 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1346850625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 MONROE ST APT 1S",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070306527",
"telephone_number": "516-244-9960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 LLOYD AVE",
"city": "LYNBROOK",
"state": "NY",
"postal_code": "115634045",
"telephone_number": "516-244-9960"
}
],
"practiceLocations": [
{
"address_1": "79 Monroe St Apt 1S",
"address_purpose": "LOCATION",
"city": "Hoboken",
"state": "NJ",
"postal_code": "070306527",
"country_code": "US",
"telephone_number": "516-244-9960",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAPOFF",
"first_name": "MALLORY",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-03",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "023779",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS PSYCHOLOGIST LICENSE",
"identifier": "023779",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "restorativeinsight.com",
"affiliation": "N",
"endpointDescription": "Domain",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "79 Monroe St Apt 1S",
"city": "Hoboken",
"state": "NJ",
"country_code": "US",
"postal_code": "070306527",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lynbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.