Healthcare Provider Details

I. General information

NPI: 1508442161
Provider Name (Legal Business Name): STEFANO MALERBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 1ST AVE
NEW YORK NY
10003-2925
US

IV. Provider business mailing address

281 1ST AVE
NEW YORK NY
10003-2925
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number338870
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: