Provider Demographics
NPI:1891966990
Name:DR. FOSTER R. MALMED, D.C., P.C.
Entity Type:Organization
Organization Name:DR. FOSTER R. MALMED, D.C., P.C.
Other - Org Name:DR. FOSTER R. MALMED & ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-279-3400
Mailing Address - Street 1:2505 CARMEL AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-1155
Mailing Address - Country:US
Mailing Address - Phone:845-279-3400
Mailing Address - Fax:
Practice Address - Street 1:2505 CARMEL AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-1155
Practice Address - Country:US
Practice Address - Phone:845-279-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003821-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXCWBA1Medicare PIN