Lisa A Marder, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

012718 Issued in NY

Practice address

482 Bard Avenue
Staten Island, NY 10310

Phone

(718) 815-7609

NPI assigned

Oct 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

Specialty

Clinical Psychologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Senior Life Management, P.L.L.C.

  • Clinical Psychologist
  • Carle Place, NY
  • NPI 1396799557
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760578058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 BARD AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10310",
            "telephone_number": "718-815-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 BARD AVENUE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10310",
            "telephone_number": "718-815-7609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDER",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J Marcinczuk, D.D.S.
• Linda Marconi-Manda, PHD
• Marina Marcus, PHARMD, BCPS, BCMTMS
• Stephanie Marcus
• Hanna Mardakh, PA
• Irene Dorothy Maresca
• Brianna Rose Marfa, CCC-SLP
• Margaret Ultra Home Care Inc
• Margaret Ultra Home Care Inc.
• Sarah E Margiotta, OT

• Clinical Psychologist in Staten Island, NY
• Providers in Staten Island, 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 Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.