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General NPI Number Information
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NPI Number | 1558595801
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Entity Type | Individual
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Provider Name | CYNTHIA LOUISE MALIN APN
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Gender | Female
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 1113 HOSPITAL DR 1ST FLOOR
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City | WILLINGBORO
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State | NJ
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Zip | 08046-1103
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Country | US
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Telephone | 609-835-5821
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Fax | 609-835-5827
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Provider Business Mailing Address
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Address Line | 500 GROVE ST SUITE 100
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City | HADDON HEIGHTS
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State | NJ
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Zip | 08035-1761
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Country | US
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Telephone | 856-796-9200
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Fax | 856-796-9397
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP010300
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP010300
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00283000
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License Number State | NJ
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