Basic Information
| Provider Information | |||||||||
| NPI: | 1295389377 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALAWER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MA, CCC-A, FAAA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14 BROWERS LN | ||||||||
| Address2: | |||||||||
| City: | ROSLYN HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115772103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165320262 | ||||||||
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| Practice Location | |||||||||
| Address1: | 131 JERICHO TPKE STE C | ||||||||
| Address2: | |||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115011800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162940127 | ||||||||
| FaxNumber: | 5166405115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2019 | ||||||||
| LastUpdateDate: | 11/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | 000500-1 | NY | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.