Provider Demographics
NPI:1043574056
Name:MALONEY, JEANMARIE C (AUD)
Entity Type:Individual
Prefix:
First Name:JEANMARIE
Middle Name:C
Last Name:MALONEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JEANMARIE
Other - Middle Name:C
Other - Last Name:MALONEY HANSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:96 CARLEY AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3231
Mailing Address - Country:US
Mailing Address - Phone:516-314-5526
Mailing Address - Fax:
Practice Address - Street 1:72 FARMEDGE RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-5202
Practice Address - Country:US
Practice Address - Phone:516-314-5526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001543231H00000X
NY006996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist