Provider Demographics
NPI:1932626520
Name:ASHOK MALAYIL, ALEENA (FNP)
Entity Type:Individual
Prefix:
First Name:ALEENA
Middle Name:
Last Name:ASHOK MALAYIL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ALEENA
Other - Middle Name:
Other - Last Name:PRABHAKAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:111 CLOCK TOWER CMNS
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:NY
Mailing Address - Zip Code:10509-4055
Mailing Address - Country:US
Mailing Address - Phone:845-279-5187
Mailing Address - Fax:845-279-5168
Practice Address - Street 1:664 STONELEIGH AVE STE 100
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3990
Practice Address - Country:US
Practice Address - Phone:845-279-5616
Practice Address - Fax:845-279-5168
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2017-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF342091363LF0000X
NYF342091-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily