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General NPI Number Information
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NPI Number | 1801922323
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Entity Type | Individual
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Provider Name | STACY MALIN PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 W 64TH ST SUITE 1C
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City | NEW YORK
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State | NY
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Zip | 10023-6734
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Country | US
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Telephone | 212-874-5886
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Fax |
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Provider Business Mailing Address
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Address Line | 103 E 86TH ST # 10B
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City | NEW YORK
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State | NY
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Zip | 10028-1058
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Country | US
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Telephone | 212-722-6911
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Fax | 212-722-6408
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 009753-1
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License Number State | NY
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