MEDICARE: MS. MARIE ANN DEFRANCESCO-MALVIYA CRNA

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	163W00000X	Registered Nurse	RN-536142	PA
2	363L00000X	Nurse Practitioner	R208342	MD
3	363L00000X	Nurse Practitioner	332252	NY
4	363L00000X	Nurse Practitioner	SP007322	PA
5	367500000X	Certified Registered Nurse Anesthetist	081633	PA
6	367500000X	Certified Registered Nurse Anesthetist	R208342	MD

General Provider Information

NPI Number	:	1376594010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIE ANN DEFRANCESCO-MALVIYA CRNA

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:
Fax Number	:	410-955-8309

Provider Business Practice Location Address
First Line	:	5450 KNOLL NORTH DR STE 301
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2373
Country	:	US
Telephone Number	:	443-546-1700
Fax Number	:

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	12/20/2023

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Directions to “ MS. MARIE ANN DEFRANCESCO-MALVIYA CRNA” Practice Location

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