Dr Mala Datta, PH,D - Medicare Psychologist in Hackensack, NJ

Dr Mala Datta, PH,D is a medicare enrolled "Psychologist" provider in Hackensack, New Jersey. Her current practice location is 294-298 State St Ste 1, Hackensack, New Jersey. You can reach out to her office (for appointments etc.) via phone at (201) 952-9905.

Dr Mala Datta is licensed to practice in New York (license number 01271101) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1184812513.

Contact Information

Dr Mala Datta, PH,D
294-298 State St Ste 1,
Hackensack, NJ 07601-5544
(201) 952-9905
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Mala Datta
GenderFemale
SpecialityPsychologist
Location294-298 State St Ste 1, Hackensack, New Jersey
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1184812513
  • Provider Enumeration Date: 10/10/2007
  • Last Update Date: 11/06/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 3577650704
  • Enrollment ID: I20071105000003

Medical Identifiers

Medical identifiers for Dr Mala Datta such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1184812513NPI-NPPES
01271101OtherNYNYS LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 35S100543600 (New Jersey)Secondary
103T00000XPsychologist 012711 (New York)Secondary
103T00000XPsychologist 01271101 (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mala Datta is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Mala Datta, PH,D
259 Massachusetts Ave Ste 1,
Haworth, NJ 07641-1808

Ph: (201) 952-9905
Dr Mala Datta, PH,D
294-298 State St Ste 1,
Hackensack, NJ 07601-5544

Ph: (201) 952-9905

Reviews and Comments


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