Provider Demographics
NPI:1184932279
Name:MALOY, KAREN A
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:A
Last Name:MALOY
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 1:64 APPLEBY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3510
Mailing Address - Country:US
Mailing Address - Phone:718-987-5434
Mailing Address - Fax:
Practice Address - Street 1:64 APPLEBY AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3510
Practice Address - Country:US
Practice Address - Phone:718-987-5434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator