MEDICARE: JOANNE J. MALINA MD

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
1	207R00000X	Internal Medicine Physician	215563-1	NY
2	207R00000X	Internal Medicine Physician	H0593	TX

General Provider Information

NPI Number	:	1063491173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE J. MALINA MD

Provider Business Mailing Address
First Line	:	PO BOX 231
Second Line	:
City	:	MONTROSE
State	:	NY
Zip	:	10548-0231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2094 ALBANY POST RD
Second Line	:
City	:	MONTROSE
State	:	NY
Zip	:	10548-1454
Country	:	US
Telephone Number	:	914-737-4400
Fax Number	:	914-788-4244

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	07/08/2007

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