Active NPI
Aviva Y Marlin, PSYD
- Clinical Neuropsychologist
- Bethlehem, PA
National Provider Identifier
1962891663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PS018374
- Practice address
- 1417 8TH Ave
Bethlehem, PA 18018-2256 - Phone
- (484) 526-5210
- Fax
- (484) 526-5237
- NPI assigned
- Jan 18, 2015
- 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 Neuropsychologist | 103G00000X | PS018374 | PA | Primary |
Addresses
Primary practice location
1417 8TH Ave
Bethlehem, PA 18018-2256
Mailing address
1417 8TH Ave
Bethlehem, PA 18018-2256
Phone (484) 526-5210
Other practice location 1
3724 Olentangy River Rd Ste A
Columbus, OH 43214-3456
Phone (614) 566-5858
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS018374 | PA | MD | Clinical Neuropsychologist |
Interoperability endpoints
- aviva.marlin@slpg.direct-sluhn.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1518998400000",
"number": "1962891663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1417 8TH AVE",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180182256",
"telephone_number": "484-526-5210",
"fax_number": "484-526-5237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 8TH AVE",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180182256",
"telephone_number": "484-526-5210",
"fax_number": "484-526-5237"
}
],
"practiceLocations": [
{
"address_1": "3724 Olentangy River Rd Ste A",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432143456",
"country_code": "US",
"telephone_number": "614-566-5858",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARLIN",
"first_name": "AVIVA",
"middle_name": "Y",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-18",
"last_updated": "2018-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "PA",
"license": "PS018374",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.