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NPI Code Detail

MEDICARE: DR. RONALD M MALEN D.M.D.

MEDICARE: DR. RONALD M MALEN D.M.D.
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
11223G0001XGeneral Practice Dentistry032284NY

General Provider Information

NPI Number : 1407842446
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD M MALEN D.M.D.
Provider Business Mailing Address
First Line : 142 JORALEMON ST
Second Line : SUITE 6-E
City : BROOKLYN
State : NY
Zip : 11201-4709
Country : US
Telephone Number : 718-624-1970
Fax Number : 718-522-0503
Provider Business Practice Location Address
First Line : 142 JORALEMON ST
Second Line : SUITE 6-E
City : BROOKLYN
State : NY
Zip : 11201-4709
Country : US
Telephone Number : 718-624-1970
Fax Number : 718-522-0503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 07/08/2007

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