Healthcare Provider Details

I. General information

NPI: 1487769162
Provider Name (Legal Business Name): JUNAID Y MALEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 05/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 COLLYER ST SUITE 302
PROVIDENCE RI
02904-1869
US

IV. Provider business mailing address

PO BOX 16149
RUMFORD RI
02916-0697
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-3236
  • Fax: 401-793-5171
Mailing address:
  • Phone: 401-453-9625
  • Fax: 401-435-7069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number230142
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD14234
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: