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General NPI Number Information
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NPI Number | 1841334851
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Entity Type | Individual
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Provider Name | JOCELYN S. MALKIN MD
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Gender | Female
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 100 TEMPLE ST APT PH09
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City | NEW HAVEN
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State | CT
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Zip | 06510-2711
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Country | US
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Telephone | 203-691-6425
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Fax | 203-823-9745
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Provider Business Mailing Address
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Address Line | 100 TEMPLE ST APT PH09
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City | NEW HAVEN
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State | CT
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Zip | 06510-2711
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Country | US
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Telephone | 203-691-6425
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Fax | 203-823-9745
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | D0007177
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 007614
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License Number State | CT
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