Provider Demographics
NPI:1255131256
Name:MALONE, TANJA
Entity type:Individual
Prefix:
First Name:TANJA
Middle Name:
Last Name:MALONE
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 1:347 FRANKLIN STREET
Mailing Address - Street 2:SUITE1
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003
Mailing Address - Country:US
Mailing Address - Phone:973-951-6981
Mailing Address - Fax:
Practice Address - Street 1:347 FRANKLIN STREET
Practice Address - Street 2:SUITE1
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003
Practice Address - Country:US
Practice Address - Phone:973-951-6981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744G0900XOther Service ProvidersSpecialistGraphics Designer