Basic Information
| Provider Information | |||||||||
| NPI: | 1538333612 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALIA | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | E | ||||||||
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| Mailing Information | |||||||||
| Address1: | 232 CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065191610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035033300 | ||||||||
| FaxNumber: | 2034013352 | ||||||||
| Practice Location | |||||||||
| Address1: | 232 CEDAR ST | ||||||||
| Address2: | |||||||||
| City: | NEW HAVEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065191610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2035033300 | ||||||||
| FaxNumber: | 2034013352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2008 | ||||||||
| LastUpdateDate: | 04/18/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 03-488837 | CT | Y | Nursing Service Providers | Registered Nurse |
No ID Information.