Active NPI
Amita Santra Marks, PH.D.
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1376829101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 018369-1
- Practice address
- 3512 Quentin Rd
Ste 110
Brooklyn, NY 11234-4231 - Phone
- (800) 275-3243
- NPI assigned
- Oct 25, 2011
- 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 | 018369-1 | NY | Primary |
Addresses
Primary practice location
3512 Quentin Rd
Ste 110
Brooklyn, NY 11234-4231
Mailing address
3512 Quentin Rd
Ste 110
Brooklyn, NY 11234-4231
Phone (800) 275-3243
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018369-1 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468540800000",
"number": "1376829101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3512 QUENTIN RD",
"address_2": "STE 110",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112344231",
"telephone_number": "800-275-3243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3512 QUENTIN RD",
"address_2": "STE 110",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112344231",
"telephone_number": "800-275-3243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "AMITA",
"middle_name": "SANTRA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-25",
"last_updated": "2016-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "018369-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.