Provider Demographics
NPI:1801151766
Name:KAREN MALASKI OD & ASSOCIATES LLC
Entity type:Organization
Organization Name:KAREN MALASKI OD & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MALASKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:312-209-2005
Mailing Address - Street 1:24539 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3780
Mailing Address - Country:US
Mailing Address - Phone:216-291-0120
Mailing Address - Fax:216-291-0542
Practice Address - Street 1:28700 CHAGRIN BLVD STE 11
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-292-3937
Practice Address - Fax:216-292-5599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5493-T2405152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4144591Medicare PIN
OHV01820Medicare UPIN