Healthcare Provider Details

I. General information

NPI: 1952677502
Provider Name (Legal Business Name): MARIA JOSEFA MALAGA ARAGON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2012
Last Update Date: 04/06/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 E 17TH ST 2ND FLOOR - ROOM 223
NEW YORK NY
10003-3821
US

IV. Provider business mailing address

640 RIVERSIDE DR APT 10B
NEW YORK NY
10031-6943
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-3743
  • Fax:
Mailing address:
  • Phone: 917-280-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2021011004
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number285931
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: