Provider Demographics
NPI:1801825799
Name:MALONEY, LOUISE M (MD)
Entity type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:M
Last Name:MALONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 WILDWOOD MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:CT
Mailing Address - Zip Code:06426-1155
Mailing Address - Country:US
Mailing Address - Phone:860-767-9940
Mailing Address - Fax:860-767-9775
Practice Address - Street 1:9 WILDWOOD MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:CT
Practice Address - Zip Code:06426-1155
Practice Address - Country:US
Practice Address - Phone:860-767-9940
Practice Address - Fax:860-767-9775
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT028466207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2215741OtherAETNA ID
CTP2137092OtherOXFORD ID
CT3700042OtherCIGNA ID
CT001284661-02OtherBLUECARE FAMILY PLAN
CT010-028466-CT03OtherANTHEM ID
CT001284661Medicaid
CT028466OtherCONNECTICARE ID
CTOV6685OtherHEALTHNET ID
CT010-028466-CT03OtherANTHEM ID
CT2215741OtherAETNA ID