Maxine Lorraine Malcolm, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

661248-1 Issued in NY

Practice address

4462 Park Ave
Bronx, NY 10457-2438

Phone

(212) 582-9100

Fax

(212) 956-0526

NPI assigned

Sep 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Maxine Hall Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1619451010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 SIXTH AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108031202",
            "telephone_number": "646-209-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4462 PARK AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104572438",
            "telephone_number": "212-582-9100",
            "fax_number": "212-956-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "MAXINE",
        "middle_name": "LORRAINE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "661248-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAXINE",
            "last_name": "HALL",
            "credential": "MAXINE MALCOLM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Avinash Malaviya
• Devin Malbreaux
• Sharon Malcolm-Miller, NURSE PRACTITIONER
• Avery Malcolm
• Dionne Malcolm, RN
• Tiffany Malcolm
• Yolanda Malcolm
• Wanda Maldanado, LPN
• Anita Maldonado
• Darlene Denise Maldonado, M.A.

• Registered Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.