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General NPI Number Information
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NPI Number | 1497821029
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Entity Type | Individual
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Provider Name | MALIA N HARRISON RPA C
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Gender | Female
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 1167 NOSTRAND AVENUE CARIBBEAN HOUSE HEALTH CENTER
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City | BROOKLYN
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State | NY
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Zip | 11225
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Country | US
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Telephone | 718-778-0198
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Fax | 718-221-8169
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Provider Business Mailing Address
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Address Line | 79 MADISON AVENUE FLOOR 6 COMMUNITY HEALTHCARE NETWORK INC
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City | NEW YORK
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State | NY
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Zip | 10016
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Country | US
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Telephone | 212-545-2400
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Fax | 646-312-0481
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 010550
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License Number State | NY
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