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General NPI Number Information
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NPI Number | 1295757177
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Entity Type | Individual
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Provider Name | SUANNE GARBER MALLENBAUM MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1 WEST AVE SUITE 215
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City | LARCHMONT
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State | NY
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Zip | 10538-2470
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Country | US
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Telephone | 914-834-4379
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Fax | 914-381-2633
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Provider Business Mailing Address
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Address Line | PO BOX 318H
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City | SCARSDALE
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State | NY
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Zip | 10583-8818
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Country | US
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Telephone | 914-382-6308
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Fax | 914-381-6308
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0005X
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Taxonomy Name | Neurodevelopmental Disabilities Physician
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License Number | 183699
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 183699
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License Number State | NY
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