Provider Demographics
NPI:1336260017
Name:MEYER, MALIN AND ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:MEYER, MALIN AND ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-584-5331
Mailing Address - Street 1:418 GEYSER RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-6002
Mailing Address - Country:US
Mailing Address - Phone:518-584-5331
Mailing Address - Fax:518-584-5332
Practice Address - Street 1:418 GEYSER RD
Practice Address - Street 2:SUITE 14
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-6002
Practice Address - Country:US
Practice Address - Phone:518-584-5331
Practice Address - Fax:518-584-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA1265Medicare ID - Type Unspecified