Provider Demographics
NPI:1710742788
Name:PUFFER, MALAIKA (BS)
Entity Type:Individual
Prefix:
First Name:MALAIKA
Middle Name:
Last Name:PUFFER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:PUFFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:390 RIVER STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2229
Mailing Address - Country:US
Mailing Address - Phone:802-886-4500
Mailing Address - Fax:802-886-4520
Practice Address - Street 1:51 FAIRVIEW STREET
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-2579
Practice Address - Country:US
Practice Address - Phone:802-254-6028
Practice Address - Fax:802-886-4520
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker