Healthcare Provider Details

I. General information

NPI: 1770355315
Provider Name (Legal Business Name): ORLE MALEBRANCHE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3116 32ND ST APT 1D
ASTORIA NY
11106-2500
US

IV. Provider business mailing address

200 W 57TH ST STE 307
NEW YORK NY
10019-3211
US

V. Phone/Fax

Practice location:
  • Phone: 516-244-1697
  • Fax:
Mailing address:
  • Phone: 917-410-6905
  • Fax: 646-878-6095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number421661
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: