Provider Demographics
NPI:1962835470
Name:MALYAROVICH, ALEXANDER E (SCD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:E
Last Name:MALYAROVICH
Suffix:
Gender:M
Credentials:SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 NEWTON SPARTA RD STE 1C
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2773
Mailing Address - Country:US
Mailing Address - Phone:973-383-4100
Mailing Address - Fax:973-383-4104
Practice Address - Street 1:39 NEWTON SPARTA RD STE 1C
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2773
Practice Address - Country:US
Practice Address - Phone:973-383-4100
Practice Address - Fax:973-383-4104
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00085900231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist