Provider Demographics
NPI:1073785051
Name:MALUF, JEANNETTE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:M
Last Name:MALUF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JEANNETTE
Other - Middle Name:M
Other - Last Name:MALUF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:61 W 62ND ST APT 4H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7016
Mailing Address - Country:US
Mailing Address - Phone:212-262-0295
Mailing Address - Fax:212-246-0088
Practice Address - Street 1:61 W 62ND ST APT 4H
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7016
Practice Address - Country:US
Practice Address - Phone:212-262-0295
Practice Address - Fax:212-246-0088
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-30
Last Update Date:2008-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009382-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical