Individual provider Active NPI

Mallory Stauber

  • School Psychologist
  • New York, NY
National Provider Identifier
1467762708
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
Practice address
475 Riverside Dr
Suite 730
New York, NY 10115-0002
Phone
(212) 280-4473
Fax
(212) 280-5384
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X Primary

Addresses

Primary practice location

475 Riverside Dr
Suite 730
New York, NY 10115-0002

Mailing address

475 Riverside Dr
Suite 730
New York, NY 10115-0002

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1467762708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 RIVERSIDE DR",
            "address_2": "SUITE 730",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101150002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 RIVERSIDE DR",
            "address_2": "SUITE 730",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101150002",
            "telephone_number": "212-280-4473",
            "fax_number": "212-280-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUBER",
        "first_name": "MALLORY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.