Provider Demographics
NPI:1972207488
Name:MAL, CHANO (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANO
Middle Name:
Last Name:MAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CHANO
Other - Middle Name:PARKASH
Other - Last Name:MAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 BROOKDALE PLZ
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3139
Mailing Address - Country:US
Mailing Address - Phone:718-240-6205
Mailing Address - Fax:718-240-6516
Practice Address - Street 1:1 BROOKDALE PLZ
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3139
Practice Address - Country:US
Practice Address - Phone:718-240-6205
Practice Address - Fax:718-240-6516
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program