Brian Fisher Mahon, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

006687-1 Issued in NY

Practice address

415 E 85TH St Apt 11CD
New York, NY 10028-6363

Phone

(212) 988-6435

NPI assigned

Apr 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2022 through Jul 1, 2028

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1528181518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E 85TH ST APT 11CD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100286363",
            "telephone_number": "212-988-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E 85TH ST APT 11CD",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100286363",
            "telephone_number": "212-988-6435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "226 E 70th St",
            "address_2": "Suite 1-B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100215428",
            "country_code": "US",
            "telephone_number": "212-988-6435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHON",
        "first_name": "BRIAN",
        "middle_name": "FISHER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2021-06-10",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "006687-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arif Iftekar Mahmud
• Farah Mahmud
• Pamela Mahmud, MD
• Yussra Mahmud
• Berfin Mahmut, PT, DPT, CLT
• Denise Mary Mahon, RN
• Elizabeth Anne Mahon, OTR/L
• Eugene J. Mahon, M.D.
• Frederick Mahon, P.T.
• John Mahon, MD

• Clinical Psychologist in New York, NY
• Providers in New York, 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 Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.