Active NPI
David M Mahalick, PH.D.
- Clinical Neuropsychologist
- Maplewood, NJ
National Provider Identifier
1962617811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 2582
- Practice address
- 2066 Millburn Ave
Suite 201
Maplewood, NJ 07040-3727 - Phone
- (908) 832-6629
- Fax
- (973) 313-1666
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 2582 | NJ | Primary |
| Clinical Neuropsychologist | 103G00000X | 013948DUP | NY |
Addresses
Primary practice location
2066 Millburn Ave
Suite 201
Maplewood, NJ 07040-3727
Mailing address
2066 Millburn Ave
Suite 201
Maplewood, NJ 07040-3727
Phone (973) 313-9393
Other names 1
- Dr. D M Mahalick
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2582 | NJ | MD | Clinical Neuropsychologist |
| 013948DUP | NY | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurobehavioral Institute of New Jersey, P.a. | Clinical Neuropsychologist | Past | Accepting new patients |
Interoperability endpoints
- dmahalick59306@epicdirect.rwjbh.org
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Psychologist
- Raritan, NJ
- NPI 1942348776
Clinical Neuropsychologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412553600000",
"number": "1962617811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2066 MILLBURN AVE",
"address_2": "SUITE 201",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070403727",
"telephone_number": "973-313-9393",
"fax_number": "973-313-1666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2066 MILLBURN AVE",
"address_2": "SUITE 201",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070403727",
"telephone_number": "908-832-6629",
"fax_number": "973-313-1666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHALICK",
"first_name": "DAVID",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2014-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NJ",
"license": "2582",
"primary": true
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "NY",
"license": "013948DUP",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "D",
"last_name": "MAHALICK",
"middle_name": "M",
"prefix": "DR.",
"credential": "PH.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Maplewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.