Provider Demographics
NPI:1801414446
Name:MALIANI, HARUNA KIBUNDILA (PMHNP-C)
Entity type:Individual
Prefix:MR
First Name:HARUNA
Middle Name:KIBUNDILA
Last Name:MALIANI
Suffix:
Gender:
Credentials:PMHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1715
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-0029
Mailing Address - Country:US
Mailing Address - Phone:617-596-0601
Mailing Address - Fax:
Practice Address - Street 1:30 MASSACHUSETTS AVE STE 201
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-3458
Practice Address - Country:US
Practice Address - Phone:617-596-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-09
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN278416363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health