Susan Jane Morduch, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

014634 Issued in NY

Practice address

547 Saw Mill River Rd
Ste 1D
Ardsley, NY 10502-2154

Phone

(212) 851-8102

Fax

(212) 537-0102

NPI assigned

Feb 8, 2011

Last updated

Feb 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1417253485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 SAW MILL RIVER RD",
            "address_2": "STE 1D",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105022154",
            "telephone_number": "212-851-8102",
            "fax_number": "212-537-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 SAW MILL RIVER RD",
            "address_2": "STE 1D",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105022154",
            "telephone_number": "212-851-8102",
            "fax_number": "212-537-0102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3512 Quentin Road",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112344231",
            "country_code": "US",
            "telephone_number": "800-275-3243 x106",
            "fax_number": "718-854-8308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3512 Quentin Road",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112344231",
            "country_code": "US",
            "telephone_number": "800-275-3243 x106",
            "fax_number": "718-854-8308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORDUCH",
        "first_name": "SUSAN",
        "middle_name": "JANE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "014634-1",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "014634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurence Charles Miller, M.D.
• Elena Moculski
• Jill Monaco, M.P.T.
• Annelyn Monakil
• Kathy Monda, PT
• Debra F Morrison-Dyke, PH.D
• Melissa Leigh Morrissey, MD
• Judith Tamara Moskowitz, PH.D
• Darshana Jagdish Naik, PT
• Julie Ann Nee, PT

• Clinical Psychologist in Ardsley, NY
• Providers in Ardsley, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.