Provider Demographics
NPI:1518138445
Name:MALONE, BETH A (MA)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:MALONE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:258 HOOSICK ST
Practice Address - Street 2:SUITE 100
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2444
Practice Address - Country:US
Practice Address - Phone:518-272-0232
Practice Address - Fax:518-272-4083
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNGA791OtherEMPIRE BLUECROOS BLUESHIELD
NY761286OtherVALUE OPTIONS