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General NPI Number Information
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NPI Number | 1710533187
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Entity Type | Individual
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Provider Name | HAROON S MALIK PSYD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2019
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 23 PLEASANT ST
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City | NEWTON
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State | MA
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Zip | 02459-1836
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Country | US
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Telephone | 800-333-0338
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Fax |
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Provider Business Mailing Address
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Address Line | 61 CRESCENT ST APT 7
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City | WALTHAM
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State | MA
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Zip | 02453-4353
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Country | US
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Telephone | 201-414-8586
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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 | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 11476
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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