Provider Demographics
NPI:1922418581
Name:MESHKATI, MALORIE N (MD)
Entity Type:Individual
Prefix:DR
First Name:MALORIE
Middle Name:N
Last Name:MESHKATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:MALORIE
Other - Middle Name:
Other - Last Name:MESHKATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:30 BERGEN ST
Mailing Address - Street 2:ADMC 1107
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-3000
Mailing Address - Country:US
Mailing Address - Phone:973-972-3106
Mailing Address - Fax:
Practice Address - Street 1:1184 5TH AVE FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-7817
Practice Address - Fax:212-534-5207
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292263208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics