Healthcare Provider Details

I. General information

NPI: 1275983256
Provider Name (Legal Business Name): ALLISON GRACE MALIN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON GRACE MCGRATH AU.D.

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CAROLINE ST
BALTIMORE MD
21287-0006
US

IV. Provider business mailing address

5201 LOCH RAVEN BLVD. ATTN: AUDIOLOGY
BALTIMORE MD
21239
US

V. Phone/Fax

Practice location:
  • Phone: 732-996-2693
  • Fax:
Mailing address:
  • Phone: 410-933-2704
  • Fax: 410-500-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number01392
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: