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General NPI Number Information
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NPI Number | 1235207101
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Entity Type | Individual
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Provider Name | ALFRED ADEBAYO MALOMO M.D
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 2066 HUDSON AVE
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City | ROCHESTER
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State | NY
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Zip | 14617-4300
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Country | US
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Telephone | 585-922-9919
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 ELMWOOD AVE APT 7
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City | ROCHESTER
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State | NY
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Zip | 14620-3899
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Country | US
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Telephone | 585-672-1322
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 002739
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License Number State | NY
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