Basic Information
| Provider Information | |||||||||
| NPI: | 1306954623 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MALKIN-INGOGLIA | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | RENEE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 556 E BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115614534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168896547 | ||||||||
| FaxNumber: | 7186302894 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 POLY PL | ||||||||
| Address2: | VANYHHCS, BROOKLYN: DEPARTMENT OF PSYCHOLOGY (116B) | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112097104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188366600 | ||||||||
| FaxNumber: | 7186302894 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 016097 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.