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NPI Code Detail

MEDICARE: DR. JENNIE O'LERA MALONE D.O.

MEDICARE:  DR. JENNIE O'LERA MALONE  D.O.
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
1207Q00000XFamily Medicine Physician258781NY
2207Q00000XFamily Medicine Physician25MB08670200NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558569814
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIE O'LERA MALONE D.O.
Provider Business Mailing Address
First Line : 3458 NEELY RD
Second Line :
City : JOINT BASE MDL
State : NJ
Zip : 08641-5312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3458 NEELY RD
Second Line :
City : JOINT BASE MDL
State : NJ
Zip : 08641-5312
Country : US
Telephone Number : 888-363-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 03/14/2018

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Directions to “ DR. JENNIE O'LERA MALONE D.O.” Practice Location

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