Healthcare Provider Details

I. General information

NPI: 1659234474
Provider Name (Legal Business Name): DR. ANASTASIA MALIK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 GREENWICH AVE
GREENWICH CT
06830-5504
US

IV. Provider business mailing address

7 STANTON LN
MARLTON NJ
08053-2469
US

V. Phone/Fax

Practice location:
  • Phone: 203-661-2721
  • Fax:
Mailing address:
  • Phone: 203-661-2721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberCT12546
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: