MEDICARE: BETH A MALONE MA

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	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NGA791	OTHER	NY	EMPIRE BLUECROOS BLUESHIELD
2	761286	OTHER	NY	VALUE OPTIONS

General Provider Information

NPI Number	:	1518138445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH A MALONE MA

Provider Business Mailing Address
First Line	:	711 TROY SCHENECTADY RD STE 203
Second Line	:
City	:	LATHAM
State	:	NY
Zip	:	12110-2461
Country	:	US
Telephone Number	:	518-782-3700
Fax Number	:	518-782-3799

Provider Business Practice Location Address
First Line	:	258 HOOSICK ST
Second Line	:	SUITE 100
City	:	TROY
State	:	NY
Zip	:	12180-2444
Country	:	US
Telephone Number	:	518-272-0232
Fax Number	:	518-272-4083

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

Provider Enumeration Date	:	03/19/2008
Last Update Date	:	01/25/2018

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Directions to “ BETH A MALONE MA” Practice Location

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