Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 271685 | NY |
N | 207L00000X | Anesthesiologist | MD423112 | PA |
N | 207QA0401X | Family Doctor - Addiction Medicine | 271685 | NY |
N | 207QA0401X | Family Doctor - Addiction Medicine | MD423112 | PA |
NPI | 1114985520 |
---|---|
Provider Name | Dr. Javaid A Malik |
First Address | North Tonawanda, NY 14120-2019 |
Second Address | Olean, NY 14760-1514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 11/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03530458 | (05) | NY |
1011409110003 | (05) | PA |
1011409110004 | (05) | PA |
H76615 | (02) |