MEDICARE: ATARA MALEK

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	251300000X	Local Education Agency (LEA)	1912517251	NY

General Provider Information

NPI Number	:	1972468379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ATARA MALEK

Provider Business Mailing Address
First Line	:	396 MARLBOROUGH RD
Second Line	:
City	:	CEDARHURST
State	:	NY
Zip	:	11516-1115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1214 HEYSON RD
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-5511
Country	:	US
Telephone Number	:	718-868-3232
Fax Number	:

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

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “ ATARA MALEK ” Practice Location

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