Erica Malloy Psychiatric Nurse Practitioner PC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

401461 Issued in NY

Legal business name

ERICA MALLOY PSYCHIATRIC NURSE PRACTITIONER PC

Doing business as

Valhalla Vitality

Practice address

16 Marietta Dr
Westbury, NY 11590-1134

Phone

(718) 459-1225

NPI assigned

Jun 6, 2018

Organization subpart

No

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

Authorized official

Name

Erica Malloy, NPNPI 1053685206

Title

President

Phone

(516) 266-6186

Specialties & licenses 1

Addresses

Other names 1

• Valhalla Vitality Doing business as

Tax ID family

Erica Malloy Psychiatric Nurse Practitioner PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Erica Malloy, Psychiatric Nurse Practitioner, P.C.

  • Psychiatric/Mental Health Nurse Practitioner
  • Rockaway Beach, NY
  • NPI 1467102806
  NPD tax ID

Practitioners 1

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

• Erica L Malloy, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1053685206
  NPD Authorized official

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1396238127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MARIETTA DR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901134",
            "telephone_number": "718-459-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MARIETTA DR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901134",
            "telephone_number": "718-459-1225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9218 Rockaway Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockaway Beach",
            "state": "NY",
            "postal_code": "116931527",
            "country_code": "US",
            "telephone_number": "516-266-6186",
            "fax_number": "445-800-8689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ERICA MALLOY PSYCHIATRIC NURSE PRACTITIONER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "MALLOY",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-266-6186",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valhalla Vitality",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Westbury, NY
• Providers in Westbury, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.