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General NPI Number Information
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NPI Number | 1518205350
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Entity Type | Individual
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Provider Name | MALKA ESRAEILIAN MS
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Gender | Female
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Dates
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Enumeration Date | 01/29/2013
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Last Update Date | 01/29/2013
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Provider Practice Location Address
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Address Line | 538 BROADHOLLOW RD SUITE 202
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City | MELVILLE
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State | NY
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Zip | 11747-3676
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Country | US
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Telephone | 631-385-7795
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Fax | 631-385-7795
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Provider Business Mailing Address
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Address Line | 31 OVERLOOK TER
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1417
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Country | US
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Telephone | 516-484-8309
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Fax | 516-484-8309
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 692399121
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 692401121
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 692401121
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License Number State | NY
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