Ali Imran Mallick

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

320321 Issued in NY

Practice address

355 Bard Ave
Department of Psychiatry, 1St Floor
Staten Island, NY 10310

Phone

(718) 818-4121

NPI assigned

May 23, 2019

Sex

Male

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: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maimonides Department of Psychiatry FPP

  • Psychiatry Physician
  • Brooklyn, NY
  • NPI 1376656710
  Medicare reassignment NPD
• Maimonides Faculty Practice Plan

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053344846
  Medicare reassignment NPD
• Anesthesiology Associates of Boro Park, LLP

  • Pain Medicine (Anesthesiology) Physician
  • Brooklyn, NY
  • NPI 1518912302
  NPD (past)
• MMC OB-GYN Faculty Practice Plan

  • Specialist
  • Brooklyn, NY
  • NPI 1306843388
  NPD (past)

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1427615665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7534 193RD ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661834",
            "telephone_number": "917-650-9930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "address_2": "DEPARTMENT OF PSYCHIATRY, 1ST FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10310",
            "telephone_number": "718-818-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLICK",
        "first_name": "ALI",
        "middle_name": "IMRAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-23",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "320321",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "320321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea D. Maller, OD
• Sandra A Mallette, RN
• Amanda Nicole Mallia, FNP-BC
• Brianna Frances Mallia, M.S., CCC-SLP
• Daniela Rose Mallia, M.S. OTR/L
• Sanford Mallin, MD
• Emily Sharon Mallinger, MD
• Scott Robert Mallon
• Ellen Malloy
• Amanda G Malone

• Psychiatry Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; 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.