Provider Demographics
NPI:1114479201
Name:MALKANI, MALINA LINKAS
Entity Type:Individual
Prefix:
First Name:MALINA
Middle Name:LINKAS
Last Name:MALKANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 RIDGELAND TER
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3407
Mailing Address - Country:US
Mailing Address - Phone:917-533-1177
Mailing Address - Fax:
Practice Address - Street 1:13 RIDGELAND TER
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3407
Practice Address - Country:US
Practice Address - Phone:917-533-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006921-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered