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General NPI Number Information
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NPI Number | 1306122874
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Entity Type | Individual
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Provider Name | LYNN MALANKA RN, RNFA, APN.C
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Gender | Female
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Dates
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Enumeration Date | 10/28/2011
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 695 US HIGHWAY 46 STE 400A
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City | FAIRFIELD
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State | NJ
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Zip | 07004-1568
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Country | US
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Telephone | 973-826-8291
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Fax | 888-972-6480
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Provider Business Mailing Address
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Address Line | 734 6TH ST
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City | SECAUCUS
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State | NJ
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Zip | 07094-3012
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Country | US
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Telephone | 201-600-2848
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | A0805236
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 26NO11473000
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License Number State | NJ
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