MEDICARE: MRS. MALKA BIRNBAUM MS ED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst		NY

General Provider Information

NPI Number	:	1023373826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MALKA BIRNBAUM MS ED

Provider Business Mailing Address
First Line	:	23 HOLDEN SQ
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5828
Country	:	US
Telephone Number	:	347-522-6032
Fax Number	:

Provider Business Practice Location Address
First Line	:	23 HOLDEN SQ
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5828
Country	:	US
Telephone Number	:	347-522-6032
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2012
Last Update Date	:	12/29/2025

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