Provider Demographics
NPI:1841334851
Name:MALKIN, JOCELYN S (MD)
Entity type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:S
Last Name:MALKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 TEMPLE ST
Mailing Address - Street 2:APT PH09
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2711
Mailing Address - Country:US
Mailing Address - Phone:203-691-6425
Mailing Address - Fax:203-823-9745
Practice Address - Street 1:100 TEMPLE ST
Practice Address - Street 2:APT PH09
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-2711
Practice Address - Country:US
Practice Address - Phone:203-691-6425
Practice Address - Fax:203-823-9745
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0007177101YM0800X
CT007614101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health