Active NPI
Vicki Anne Mammano, PSY.D
- Psychologist
- Brooklyn, NY
National Provider Identifier
1891914552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 011781
- Practice address
- 1075 50TH St
Brooklyn, NY 11219-3332 - Phone
- (718) 435-8729
- Fax
- (718) 871-6446
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 011781 | NY | Primary |
Addresses
Primary practice location
1075 50TH St
Brooklyn, NY 11219-3332
Mailing address
1717 54TH St
Brooklyn, NY 11204-1533
Phone (718) 435-8729
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 |
|---|---|---|---|
| 011781 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891914552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 54TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112041533",
"telephone_number": "718-435-8729",
"fax_number": "718-871-6446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1075 50TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112193332",
"telephone_number": "718-435-8729",
"fax_number": "718-871-6446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMMANO",
"first_name": "VICKI",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "011781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.