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NPI Code Detail

MEDICARE: MALINI C. GILLEN M.D.

MEDICARE: MALINI C. GILLEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080A0000XPediatric Adolescent Medicine PhysicianMD10597RI

General Provider Information

NPI Number : 1023091949
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALINI C. GILLEN M.D.
Provider Business Mailing Address
First Line : 2 MEEHAN LN
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-1413
Country : US
Telephone Number : 401-658-2525
Fax Number : 401-658-3031
Provider Business Practice Location Address
First Line : 2 MEEHAN LN
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-1413
Country : US
Telephone Number : 401-658-2525
Fax Number : 401-658-3031
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 07/30/2025

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