Provider Demographics
NPI:1043242753
Name:MALERBA, ROBERT F II (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:MALERBA
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:732 MADISON AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3302
Practice Address - Country:US
Practice Address - Phone:518-436-0874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1781832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10001262OtherCDPHP
NY000470152001OtherBLUE SHIELD
NY798592OtherMVP - ELLIS MENTAL HEALTH
NY412344OtherMVP - PVT. PRACTICE
NY613BP1OtherBLUE CROSS
NY11268699OtherCAQH
NY000470152001OtherBLUE SHIELD
NY613BP1OtherBLUE CROSS
NYRB0661Medicare ID - Type Unspecified