Paula Malbon, PCNS

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN264774 Issued in OH

Practice address

USA Meddac
11050 Mount Belvedere Blvd
Fort Drum, NY 13602

Phone

(315) 772-6703

NPI assigned

Jul 30, 2009

Last updated

Oct 24, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1902037500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21551 REDWOOD LN APT C",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136015961",
            "telephone_number": "216-262-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MOUNT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALBON",
        "first_name": "PAULA",
        "credential": "PCNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-30",
        "last_updated": "2022-10-24",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "RN264774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Luther
• Vania Ma, MD
• Wael K Mabrouk, DMD
• Mary Angela Macculloch, LCSW
• Owen Michael Mainord, MAT, LAT, ATC, NREMT
• Ralph Kirschner Marcellus, MSW, LCSW-R
• David R Marquez, DVM
• Tobin Northstar Marti, LMHC
• Bobbi A Massey-Campbell, LCSW
• Bridget Matsas, MD

• Psychiatric/Mental Health Nurse Practitioner in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.