Corey Kyle Malan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11403 Issued in CT

Practice address

392 State St Apt 8K
North Haven, CT 06473-3140

Phone

(860) 977-2450

NPI assigned

Jan 20, 2023

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

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1629783964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 FOREST HILL RD",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064734301",
            "telephone_number": "860-977-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "392 STATE ST APT 8K",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064733140",
            "telephone_number": "860-977-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAN",
        "first_name": "COREY",
        "middle_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-20",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "11403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petar Lujic, MD
• Shane Michael Mahon, LCSW
• Steven Mahoney Jr., LCSW
• Jacqueline Maisonpierre, MS
• Darren Major
• Alex Nikhil Malhotra
• John Maltagliati, PHARMACY TECHNICIAN
• Alexander Charles Manning, PA-C
• Michele Manny, LMSW
• Marc W Platt DC Dba/ Community Chiropractic Center

• Family Nurse Practitioner in North Haven, CT
• Providers in North Haven, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.