Individual provider Active NPI

Aaron Malark, PSYD

  • Psychologist
  • New York, NY
National Provider Identifier
1386059681
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
020637 Issued in NY
Practice address
352 7TH Ave RM 1105
New York, NY 10001-5657
Phone
(917) 704-3298
NPI assigned
Jun 25, 2014
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 020637 NY Primary

Addresses

Primary practice location

352 7TH Ave RM 1105
New York, NY 10001-5657

Mailing address

352 7TH Ave RM 1105
New York, NY 10001-5657
Phone (917) 704-3298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 9, 2024 through Jul 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
020637NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1386059681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 7TH AVE RM 1105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015657",
            "telephone_number": "917-704-3298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 7TH AVE RM 1105",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100015657",
            "telephone_number": "917-704-3298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALARK",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-25",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "020637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.