Individual provider Active NPI

Gloria Marmor, PH.D.

  • Psychologist
  • Port Washington, NY
National Provider Identifier
1609976398
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
007354-1 Issued in NY
Practice address
13 Ridgeway Rd
Port Washington, NY 11050-2729
Phone
(516) 883-3166
Fax
(516) 883-5262
NPI assigned
Sep 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 007354-1 NY Primary

Addresses

Primary practice location

13 Ridgeway Rd
Port Washington, NY 11050-2729

Mailing address

13 Ridgeway Rd
Port Washington, NY 11050-2729
Phone (516) 883-3166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100324000741 NY Practitioner - Clinical Psychologist 8820123219 Practice locations: Garden City, NY; Port Washington, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13 Ridgeway Rd
Port Washington, NY 11050-2729
Phone (516) 883-3116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
007354-1NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609976398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 RIDGEWAY RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502729",
            "telephone_number": "516-883-3166",
            "fax_number": "516-883-5262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 RIDGEWAY RD",
            "city": "PORT WASHINGTON",
            "state": "NY",
            "postal_code": "110502729",
            "telephone_number": "516-883-3166",
            "fax_number": "516-883-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMOR",
        "first_name": "GLORIA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "007354-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, NY

Sources for this page

Verify at the official NPI Registry.