Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 236963 | MA |
N | 208000000X | Pediatrician | 47264 | KY |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 47264 | KY |
NPI | 1033371216 |
---|---|
Provider Name | Jonathan R Malowitz |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2008 |
Last Update Date | 17/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000881354 | ANTHEM-KCNS (01) | KY |
1033371216 | PASSPORT-KCNS (01) | KY |
163566 | SIHO-KCNS (01) | KY |
7100309620 | (05) | KY |