Provider Demographics
NPI:1235142183
Name:MALIN, JOEL W (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:W
Last Name:MALIN
Suffix:
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 1:305 BLACK ROCK TPKE
Mailing Address - Street 2:ORTHOPAEDIC SPECIALTY GROUP
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-5508
Mailing Address - Country:US
Mailing Address - Phone:203-337-2600
Mailing Address - Fax:203-337-2666
Practice Address - Street 1:305 BLACK ROCK TPKE
Practice Address - Street 2:ORTHOPAEDIC SPECIALTY GROUP
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-5508
Practice Address - Country:US
Practice Address - Phone:203-337-2600
Practice Address - Fax:203-337-2666
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035074207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TINOtherPIONEER
CT010035074CT04OtherANTHEM BC/BS
TINOtherCORVEL
TINOtherNATIONAL PROVIDER NETWORK
TINOtherPOMCO
CT035074OtherCONNECTICARE
CT2V4877OtherHEALTH NET
TINOtherNEHCA
TINOtherFIRST HEALTH / CCN
TINOtherORTHONET
TINOtherGREAT WEST
TINOtherUNITED HEALTHCARE
CTZS1017OtherOXFORD HEALTH PLANS
CT001350743Medicaid
CT3617683OtherAETNA
CT578F1 (2) (3)OtherEMPIRE BC/BS
CT6859884006OtherCIGNA
TINOtherNORTHEAST HEALTH DIRECT
TINOtherNATIONAL PROVIDER NETWORK
TINOtherPOMCO