MEDICARE: DR. CHARLOTTE MALASKY M.D.

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	144960	NY
2	207RP1001X	Pulmonary Disease Physician	144960	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	40Q031	OTHER	NY	BLUE CROSS

General Provider Information

NPI Number	:	1831190982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLOTTE MALASKY M.D.

Provider Business Mailing Address
First Line	:	1250 WATERS PL
Second Line	:	SUITE 506
City	:	BRONX
State	:	NY
Zip	:	10461-2720
Country	:	US
Telephone Number	:	718-892-1200
Fax Number	:	718-918-1696

Provider Business Practice Location Address
First Line	:	1250 WATERS PL
Second Line	:	SUITE 506
City	:	BRONX
State	:	NY
Zip	:	10461-2720
Country	:	US
Telephone Number	:	718-892-1200
Fax Number	:	718-918-1696

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	10/28/2009

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