Provider Demographics
NPI:1982110334
Name:VERA MALEZHIK, LLC
Entity Type:Organization
Organization Name:VERA MALEZHIK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VERA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEZHIK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:170-288-2245
Mailing Address - Street 1:800 PALISADE AVE APT 1202
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4119
Mailing Address - Country:US
Mailing Address - Phone:702-882-2454
Mailing Address - Fax:
Practice Address - Street 1:115 BROADWAY STE 1800
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-1604
Practice Address - Country:US
Practice Address - Phone:702-882-2454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006856213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty