Provider Demographics
NPI:1245321553
Name:MALINA, ALAN RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:RICHARD
Last Name:MALINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:950 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2770
Mailing Address - Country:US
Mailing Address - Phone:203-465-5292
Mailing Address - Fax:203-465-5296
Practice Address - Street 1:95 SCOVILL ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1113
Practice Address - Country:US
Practice Address - Phone:203-465-5293
Practice Address - Fax:203-465-5296
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT030962207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTE44293Medicare UPIN