Marisa Gloria Malone, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

023927 Issued in NY

Practice address

1425 Portland Ave
Rochester, NY 14621-3011

Phone

(585) 922-4698

Fax

(585) 922-5702

NPI assigned

Apr 30, 2018

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

Not listed in the public Medicare enrollment file

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": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1801384300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS HWY S",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146175504",
            "telephone_number": "585-922-4698",
            "fax_number": "585-922-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213011",
            "telephone_number": "585-922-4698",
            "fax_number": "585-922-5702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Crittenden Blvd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "14624",
            "country_code": "US",
            "telephone_number": "585-275-3563",
            "fax_number": "585-276-2292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALONE",
        "first_name": "MARISA",
        "middle_name": "GLORIA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-30",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hans Malmstrom, D.D.S.
• Alfred Adebayo Malomo, M.D
• Olutoyin Modupe Malomo, MD
• Carol Lynne Malone, RN
• Chad Gregory Malone, MD
• Stephanie Malone, AUD
• Kathryn H Maloney, APRN
• Michael Maloney, M.D.
• Kamil Malshy, MD
• Taylor Malta, AGNP-C

• Clinical Psychologist in Rochester, NY
• Providers in Rochester, 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 Nov 4, 2020; 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.