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NPI Code Detail

MEDICARE: DR. GERALD OSCAR MALKIN DDS

MEDICARE: DR. GERALD OSCAR MALKIN DDS
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
1207L00000XAnesthesiology Physician12001MA

General Provider Information

NPI Number : 1265421523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD OSCAR MALKIN DDS
Provider Business Mailing Address
First Line : 11 OLDE LANTERN RD
Second Line :
City : ACTON
State : MA
Zip : 01720-2011
Country : US
Telephone Number : 978-263-3467
Fax Number :
Provider Business Practice Location Address
First Line : 133 OLD ROAD TO 9 ACRE COR
Second Line : EMERSON HOSPITAL DEPARTMENT OF ANESTHESIA
City : CONCORD
State : MA
Zip : 01742-4159
Country : US
Telephone Number : 978-287-3162
Fax Number : 978-287-3508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 11/30/2011

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