Provider Demographics
NPI:1023070646
Name:MALONEY, KEVIN J (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:J
Last Name:MALONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:144 E BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3701
Mailing Address - Country:US
Mailing Address - Phone:914-381-2091
Mailing Address - Fax:914-381-2053
Practice Address - Street 1:144 E BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3701
Practice Address - Country:US
Practice Address - Phone:914-381-2091
Practice Address - Fax:914-381-2053
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0000581OtherGHI
NYP010148317OtherSTARNET
NYWP382OtherOXFORD
NYGP148317-1OtherWORKERS COMPENSATION
NY45584286OtherMULTIPLAN
NYWS0000589OtherSELECT PRO
NY34129OtherMASTER CARE
NY45584286OtherMULTIPLAN
NYWP382OtherOXFORD