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NPI Code Detail

MEDICARE: MS. CLARICE MAALA N.P.

MEDICARE: MS. CLARICE MAALA N.P.
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
1363LG0600XGerontology Nurse PractitionerF340561NY
2363LA2200XAdult Health Nurse Practitioner303709NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205875200
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CLARICE MAALA N.P.
Provider Business Mailing Address
First Line : 3411 WAYNE AVE
Second Line : MONTEFIORE MEDICAL CENTER/ DEPARTMENT OF HEMATOLOGY
City : BRONX
State : NY
Zip : 10467-2509
Country : US
Telephone Number : 718-920-6310
Fax Number :
Provider Business Practice Location Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number : 718-920-5731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 05/29/2026

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Directions to “ MS. CLARICE MAALA N.P.” Practice Location

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