Provider Demographics
NPI:1598486680
Name:MALAK, DELANEY
Entity Type:Individual
Prefix:MS
First Name:DELANEY
Middle Name:
Last Name:MALAK
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 1:25 MICHAEL DR
Mailing Address - Street 2:
Mailing Address - City:COTTEKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12419-5106
Mailing Address - Country:US
Mailing Address - Phone:845-750-7381
Mailing Address - Fax:
Practice Address - Street 1:65 FORDING PLACE RD
Practice Address - Street 2:
Practice Address - City:LAKE KATRINE
Practice Address - State:NY
Practice Address - Zip Code:12449-5221
Practice Address - Country:US
Practice Address - Phone:845-943-3941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health