MEDICARE: DR. PATRICK JAMES MALONZO PHARMD

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	183500000X	Pharmacist	062476	NY

General Provider Information

NPI Number	:	1457978744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK JAMES MALONZO PHARMD

Provider Business Mailing Address
First Line	:	11 OXFORD DR APT 28
Second Line	:
City	:	VALLEY COTTAGE
State	:	NY
Zip	:	10989-1978
Country	:	US
Telephone Number	:	845-304-8703
Fax Number	:

Provider Business Practice Location Address
First Line	:	1575 ROUTE 9
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-2827
Country	:	US
Telephone Number	:	845-632-9020
Fax Number	:

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

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	07/02/2020

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