Provider Demographics
NPI:1013573096
Name:MALINOWSKI, AMY (CGC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:MALINOWSKI
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W PRATT ST STE 880
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-6829
Mailing Address - Country:US
Mailing Address - Phone:410-328-6640
Mailing Address - Fax:
Practice Address - Street 1:250 W PRATT ST STE 880
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-6829
Practice Address - Country:US
Practice Address - Phone:410-328-6640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAGC000456170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS