Andrea Malcolm, REGISTER NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

785282-01 Issued in NY

Practice address

433 Dunham Ave
Mount Vernon, NY 10553-2005

Phone

(347) 549-6013

NPI assigned

Oct 25, 2023

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

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": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1750153474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 DUNHAM AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105532005",
            "telephone_number": "347-549-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 DUNHAM AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105532005",
            "telephone_number": "347-549-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALCOLM",
        "first_name": "ANDREA",
        "credential": "REGISTER NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "785282-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahriar Mahmoudiani, MD
• Kaycia S Mahon
• Jamilah Maiga
• Tracy Chauna Mairs, LCSW
• Eric Makolo, MD
• Zoe Malliaros
• Marisol Mancebo
• Mark G Mandato, D.P.M.
• John P Manfredi, D.C.
• Pauline C Manhertz, SPECIAL EDUCATOR

• Registered Nurse in Mount Vernon, NY
• Providers in Mount Vernon, 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 Oct 25, 2023; 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.