Healthcare Provider Details

I. General information

NPI: 1811916174
Provider Name (Legal Business Name): BRENDA I. MALONEY C.N.M
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 HOSPITAL DR STE 501
HOLYOKE MA
01040
US

IV. Provider business mailing address

15 HOSPITAL DR STE 501
HOLYOKE MA
01040-6606
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2826
  • Fax: 413-534-2829
Mailing address:
  • Phone: 413-534-2826
  • Fax: 413-534-2829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number160080
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: