Healthcare Provider Details

I. General information

NPI: 1730708694
Provider Name (Legal Business Name): CHELSEY RYAN MALHAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2020
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NEW YORK AVE # 25A
SMITHTOWN NY
11787-3448
US

IV. Provider business mailing address

50 NEW YORK AVE # 25A
SMITHTOWN NY
11787-3448
US

V. Phone/Fax

Practice location:
  • Phone: 631-862-3000
  • Fax:
Mailing address:
  • Phone: 631-862-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number327297
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number327297
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: