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NPI Code Detail

MEDICARE: JOHN VINCENT MALONE

MEDICARE: JOHN VINCENT MALONE
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578459053
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN VINCENT MALONE
Provider Business Mailing Address
First Line : 42 TURTLE COVE LN
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-3864
Country : US
Telephone Number : 631-449-5541
Fax Number : 631-449-5541
Provider Business Practice Location Address
First Line : 368 W UWCHLAN AVE
Second Line :
City : DOWNINGTOWN
State : PA
Zip : 19335-3319
Country : US
Telephone Number : 610-269-2661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2025
Last Update Date : 06/13/2025

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