Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 145946 | NY |
NPI | 1013902493 |
---|---|
Provider Name | Barbara Malach |
First Address | Staten Island, NY 10306-4353 |
Second Address | Staten Island, NY 10306-4353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C10276 | (02) | NY |