Jessica Faye Maloy, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

001534-1 Issued in NY

Practice address

80 Vandenburgh Ave
Troy, NY 12180-6037

Phone

(845) 863-9617

NPI assigned

Apr 4, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Faye Lustbader Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445126400000",
    "number": "1144493750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CHERRY LN",
            "city": "GHENT",
            "state": "NY",
            "postal_code": "120751201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 VANDENBURGH AVE",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121806037",
            "telephone_number": "845-863-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOY",
        "first_name": "JESSICA",
        "middle_name": "FAYE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2015-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "001534-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LUSTBADER",
            "middle_name": "FAYE",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wallace Mallery
• Beth A Malone, MA
• Brenda Kimberly Maloney, MSED.
• Jessica Marie Maloney, MS, OTR/L
• Matthew Maloney, CPRA-P
• Susan Ann Maloy, MSED
• Michael S. Malsch, D.D.S.
• Beth Marie Maney, RPH
• Manhattan Medical & Psychiatric Services, PC
• Andrea Marie Manion, MS SPECIAL ED

• Athletic Trainer in Troy, NY
• Providers in Troy, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2015; 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.