David L Marasciullo PH.D,Psychologist, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3879 Issued in NY

Legal business name

DAVID L MARASCIULLO PH.D,PSYCHOLOGIST, PC

Practice address

18 S Hollow Rd
Dix Hills, NY 11746-6140

Phone

(631) 643-7390

Fax

(631) 643-5068

NPI assigned

Mar 28, 2007

Last updated

May 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Louis Marasciullo, PHD

Title

Clinical Director

Phone

(631) 643-7390

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306281600000",
    "number": "1518086735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 S HOLLOW RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466140",
            "telephone_number": "631-643-7390",
            "fax_number": "631-643-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 S HOLLOW RD",
            "city": "DIX HILLS",
            "state": "NY",
            "postal_code": "117466140",
            "telephone_number": "631-643-7390",
            "fax_number": "631-643-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID L MARASCIULLO PH.D,PSYCHOLOGIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2011-05-25",
        "status": "A",
        "authorized_official_last_name": "MARASCIULLO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "631-643-7390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "3879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02927659",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGY LICENSE",
            "identifier": "3879",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMPENSATION",
            "identifier": "S0879-4 B",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Dix Hills, NY
• Providers in Dix Hills, 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 May 25, 2011; 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.