Nerissa Malabanan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA06095100 Issued in NJ

Practice address

1222 Kennedy Blvd
Bayonne, NJ 07002-9211

Phone

(201) 319-9800

Fax

(201) 437-9661

NPI assigned

Oct 10, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: nerissa.malabanan@direct.hobokenumc.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Humc Opco LLC

  • General Acute Care Hospital
  • Hoboken, NJ
  • NPI 1043475668
  NPD
• Westside Pediatrics,P.a.

  • Pediatrics Physician
  • Jersey City, NJ
  • NPI 1881756922
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1255428124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 KENNEDY BLVD",
            "address_2": "SUITE 2",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872436",
            "telephone_number": "201-319-9800",
            "fax_number": "201-437-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 KENNEDY BLVD",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070029211",
            "telephone_number": "201-319-9800",
            "fax_number": "201-437-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALABANAN",
        "first_name": "NERISSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06095100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7015704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahmoodah Perveen,MD
• Joanna Maida, PT, DPT
• Gary R Maita, D.M.D.
• Akram Makar
• Kevin J Makely Jr., PT
• Carmelita Pingol Malalis, M.D.
• Leilani Malibiran, R.P.T.
• Almarie Mamaril
• Kris Mammas, D.V.M.
• Miray Mankarious

• Pediatrics Physician in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; 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.