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NPI Code Detail

MEDICARE: CHELSEA DAWN MALINOWSKI

MEDICARE: CHELSEA DAWN MALINOWSKI
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
1363LG0600XGerontology Nurse Practitioner12.007207CT

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 : 1659899375
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA DAWN MALINOWSKI
Provider Business Mailing Address
First Line : 37 BRIDLEWOOD RD
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-2513
Country : US
Telephone Number : 860-424-6115
Fax Number :
Provider Business Practice Location Address
First Line : 105 CARNEGIE PL STE 103
Second Line :
City : FAYETTEVILLE
State : GA
Zip : 30214-5900
Country : US
Telephone Number : 770-716-7999
Fax Number : 770-716-8444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2017
Last Update Date : 05/10/2024

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Directions to “ CHELSEA DAWN MALINOWSKI ” Practice Location

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