John Robert Malloy Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

042-0008866 Issued in VT

Practice address

300 Flynn Ave
Burlington, VT 05401-5301

Phone

(802) 658-0400

NPI assigned

Jul 6, 2006

Last updated

Aug 21, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250812800000",
    "number": "1083646798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 PRINDLE RD",
            "city": "CHARLOTTE",
            "state": "VT",
            "postal_code": "054459180",
            "telephone_number": "802-425-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FLYNN AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015301",
            "telephone_number": "802-658-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2009-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042-0008866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN0340",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Malgeri
• Ajai K. Malhotra, MD
• Nancy Renae Malhotra, ACNP-BC
• Elizabeth N Malik, MD
• Amandine Mallet, LICSW
• Emma Allison Malone, CAA
• Kathleen Thayer Maloney, PA
• Mary E Maloney, M.D.
• Christopher Steven Manfred, M.D.
• Brennan Mangan, RN

• Psychiatry Physician in Burlington, VT
• Providers in Burlington, VT by specialty
• Psychiatry Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.