Provider Demographics
NPI:1245701382
Name:MALIEVA, NATALIA (ANP)
Entity type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:
Last Name:MALIEVA
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 VIOLET CT
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3745
Mailing Address - Country:US
Mailing Address - Phone:732-718-8500
Mailing Address - Fax:732-698-7640
Practice Address - Street 1:16 VIOLET CT
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3745
Practice Address - Country:US
Practice Address - Phone:732-718-8500
Practice Address - Fax:732-698-7640
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00880100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily