Provider Demographics
NPI:1689380255
Name:MALINI, PRIYA (NP)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:MALINI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 BOULDER BROOK CT
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-5846
Mailing Address - Country:US
Mailing Address - Phone:516-661-9017
Mailing Address - Fax:
Practice Address - Street 1:8 BOULDER BROOK CT
Practice Address - Street 2:
Practice Address - City:BELLE MEAD
Practice Address - State:NJ
Practice Address - Zip Code:08502-5846
Practice Address - Country:US
Practice Address - Phone:516-661-9017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR20819700163W00000X
NJ26NJ15081400363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse