MALLESHA MALCOLM


Address: 270-05 76th Ave, Dept. of Ob/gyn, Queens, NY 11040
Phone: 7185283432

MALLESHA MALCOLM (NPI# 1245675354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245675354
Entity Type Individual
Full Name MALLESHA MALCOLM
Credential WHNP
Practice Address 270-05 76th Ave
Dept. of Ob/gyn
Queens
NY 11040
Practice Telephone 7185283432
Enumeration Date 2013-05-02
Last Update Date 2017-10-11
NPI Deactivation Date 01/23/2015
NPI Reactivation Date 2017-10-11
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse 668050 NY Nursing Service Providers
Y 363LW0102X Nurse Practitioner
Specialization: Women's Health
421305 NY Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 270-05 76TH AVE
DEPT. OF OB/GYN
City QUEENS
State NY
Zip Code 11040

Providers in the same location

NPI Name Taxonomy Address Enumeration
1518587146 Bridget Krumholz Physical Therapist 270-05 76th Ave, Queens, NY 11040 2020-04-23
1639719651 Life-cycles Midwifery Healthcare Services, P.C. Midwife 270-05 76th Ave, Queens, NY 11010 2020-01-07
1164926093 Esra Demirel Student in an Organized Health Care Education/Training Program 270-05 76th Ave, Queens, NY 11040 2018-03-23
1447662440 Arton Isa Radiology 270-05 76th Ave, Queens, NY 11040 2014-05-24
1235441320 Polina Shats Psychiatry & Neurology 270-05 76th Ave, Queens, NY 11040 2010-07-06

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598366734 Naurin Shaki Case Management 108 Bryant Ave, New Hyde Park, NY 11040 2020-11-04
1326645920 Oksana Isakharov Marriage & Family Therapist Remote Telehealth Due To Pandemic, Remote Telehealth Due To Pandemic, NY 11040 2020-10-06
1639784036 Michelle Edith Narain Nurse Practitioner 270-05 76th Aveune, New Hyde Park, NY 11040 2020-09-11
1124636188 Shannon Maureen O'connell Physician Assistant 270-05 270th Ave, New Hyde Park, NY 11040 2020-07-16
1851929384 Hollie Brown Student in an Organized Health Care Education/Training Program 45 Lakeville Rd Ste M41, New Hyde Park, NY 11040 2020-03-30
1780211797 Miriam Tarrash Student in an Organized Health Care Education/Training Program Lijmc, 270-05 76th Avenue, New Hyde Park, NY 11040 2020-03-27
1902438971 Kristina Petrich Student in an Organized Health Care Education/Training Program Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040 2020-02-07
1528622735 David Olatunji Omole Dentist 270-05 76th Avenue Dept. of Dental Medicine / Oral And, Surgery New Hyde Park, Ny, Ny 11040, New Hyde Park, NY 11040 2019-04-24
1720642093 Thanzina Chowdhury Pharmacy 271-11 76th Ave, Queens, NY 11040 2019-04-23
1427519834 Connor William Crowley Student in an Organized Health Care Education/Training Program Office of Surgical Education Victoria M. Waithe, 270-05 76th Avenue. Research Bldg - C Level Room 039ab, New Hyde Park, NY 11040 2019-03-28
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Taxonomy Information

Taxonomy Code 363LW0102X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Women's Health

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1427295682 Kayee Haglund Nurse Practitioner 42-09 28th Street, Queens, NY 11101 2009-01-09

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1417567942 Amanpreet Karir Nurse Practitioner 1305 York Ave Ste 6, New York, NY 10021-5663 2020-08-10
1700495249 Jessica Bobadilla Nurse Practitioner 9960 63rd Rd Apt 11w, Rego Park, NY 11374-1925 2020-07-30
1144844812 Charlene Santos-alvarez Nurse Practitioner 8450 169th St Apt 502, Jamaica, NY 11432-2018 2020-05-29
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Competitor

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City QUEENS
Zip Code 11040

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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