Provider Demographics
NPI:1164289831
Name:MALAFRONTE, ANTHONY MICHAEL
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:MALAFRONTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LEDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-2128
Mailing Address - Country:US
Mailing Address - Phone:401-773-2690
Mailing Address - Fax:
Practice Address - Street 1:317 FEDERAL RD STE D5
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2428
Practice Address - Country:US
Practice Address - Phone:203-740-0582
Practice Address - Fax:203-740-0582
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT495237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist