Provider Demographics
NPI:1205623816
Name:CHANALES, MALKA
Entity type:Individual
Prefix:
First Name:MALKA
Middle Name:
Last Name:CHANALES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14739 75TH RD APT 2A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-5907
Mailing Address - Country:US
Mailing Address - Phone:347-804-6582
Mailing Address - Fax:
Practice Address - Street 1:14739 75TH RD APT 2A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-5907
Practice Address - Country:US
Practice Address - Phone:347-804-6582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist