Provider Demographics
NPI:1629780184
Name:MALANDRO, LINDSEY NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:NICOLE
Last Name:MALANDRO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11565-1626
Mailing Address - Country:US
Mailing Address - Phone:516-457-8896
Mailing Address - Fax:
Practice Address - Street 1:54 WEST AVE
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1626
Practice Address - Country:US
Practice Address - Phone:516-457-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY737076163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse