MEDICARE: DR. GEORGE M MALEGIANNAKIS 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	224662	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	224662	OTHER	NY	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376503383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE M MALEGIANNAKIS MD

Provider Business Mailing Address
First Line	:	1811 AVENUE P
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1303
Country	:	US
Telephone Number	:	718-375-7595
Fax Number	:	718-375-7559

Provider Business Practice Location Address
First Line	:	1811 AVENUE P
Second Line	:	SUITE # 1A
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1303
Country	:	US
Telephone Number	:	718-375-7595
Fax Number	:	718-375-7559

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	07/08/2007

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