Provider Demographics
NPI:1952865990
Name:MALINAK, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MALINAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 QUINT AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2524
Mailing Address - Country:US
Mailing Address - Phone:406-799-5258
Mailing Address - Fax:
Practice Address - Street 1:76 QUINT AVE APT 9
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-2524
Practice Address - Country:US
Practice Address - Phone:406-799-5258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer