Provider Demographics
NPI:1306866421
Name:MALEK, BARRI JANEEN (CNM)
Entity Type:Individual
Prefix:MRS
First Name:BARRI
Middle Name:JANEEN
Last Name:MALEK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 9TH ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4103
Mailing Address - Country:US
Mailing Address - Phone:646-519-7209
Mailing Address - Fax:
Practice Address - Street 1:514 9TH ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4103
Practice Address - Country:US
Practice Address - Phone:646-519-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001069367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP96993Medicare UPIN
NYMGM331Medicare ID - Type Unspecified