Doctor Name: | DR. SUANNE GARBER MALLENBAUM |
NPI Number: | 1295757177 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD, PHD |
License Number: | 183699 |
Business Practice Address: | 1 West Ave Suite 215 Larchmont, NY - 105382470 |
Business Phone Number: | 9148344379 |
Business Fax Number: | 9143812633 |
Mailing Address: | Po Box 318h, SCARSDALE |
State: | NY |
Postal Code: | 105838818 |
Phone Number: | 9143826308 |
Fax Number: | 9143816308 |
NPI Enumeration Date: | 07/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084P0005X |
License Number: | 183699 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Neurodevelopmental Disabilities |
Taxonomy Definition: | A pediatrician or neurologist who specializes in the diagnosis and management of chronic conditions that affect the developing and mature nervous system such as cerebral palsy, mental retardation and chronic behavioral syndromes, or neurologic conditions. |