Provider Demographics
NPI:1760812564
Name:MEYER, MALIN AND ASSOCIATES PLLC
Entity Type:Organization
Organization Name:MEYER, MALIN AND ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:518-584-5331
Mailing Address - Street 1:418 GEYSER ROAD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020
Mailing Address - Country:US
Mailing Address - Phone:518-584-5331
Mailing Address - Fax:518-584-5332
Practice Address - Street 1:101 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:NY
Practice Address - Zip Code:12822
Practice Address - Country:US
Practice Address - Phone:518-654-8511
Practice Address - Fax:518-654-8512
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEYER, MALIN & ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty