Provider Demographics
NPI:1780723338
Name:MALATY, RAGA (MD)
Entity type:Individual
Prefix:DR
First Name:RAGA
Middle Name:
Last Name:MALATY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 JACKSON AVE
Mailing Address - Street 2:#3G
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5760
Mailing Address - Country:US
Mailing Address - Phone:504-452-1044
Mailing Address - Fax:
Practice Address - Street 1:500 RODERICK ST
Practice Address - Street 2:SUITE B
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-2247
Practice Address - Country:US
Practice Address - Phone:985-380-2460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09289R2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA66178Medicaid