Active NPI
Ivy J Banach
- Clinical Social Worker
- New Rochelle, NY
National Provider Identifier
1821732223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 059270-01
- Practice address
- 175 Memorial Hwy
New Rochelle, NY 10801-5635 - Phone
- (845) 702-6810
- NPI assigned
- Apr 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 059270-01 | NY | Primary |
Addresses
Primary practice location
175 Memorial Hwy
New Rochelle, NY 10801-5635
Mailing address
175 Memorial Hwy
New Rochelle, NY 10801-5635
Phone (845) 702-6810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 059270-01 | Other | NY | STATE OF NEW YORK EDUCATION DEPARTMENT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059270-01 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651104000000",
"number": "1821732223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 MEMORIAL HWY",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108015635",
"telephone_number": "845-702-6810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 MEMORIAL HWY",
"city": "NEW ROCHELLE",
"state": "NY",
"postal_code": "108015635",
"telephone_number": "845-702-6810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANACH",
"first_name": "IVY",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-22",
"last_updated": "2022-04-28",
"certification_date": "2022-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "059270-01",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF NEW YORK EDUCATION DEPARTMENT",
"identifier": "059270-01",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Rochelle, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.