Basic Information
Provider Information
NPI: 1730464801
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MALAGON- MORRIS
FirstName: RIKKI
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2500 ENGLISH CREEK AVE, BLDG 900
Address2: STE 909
City: EGG HARBOR TOWNSHIP
State: NJ
PostalCode: 08234
CountryCode: US
TelephoneNumber: 6094072380
FaxNumber:  
Practice Location
Address1: 450 CLARKSON AVE
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112032012
CountryCode: US
TelephoneNumber: 7182704580
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/20/2011
LastUpdateDate: 10/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X278546NYY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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