Provider Demographics
NPI:1104439645
Name:MALINGS, ELYSSA
Entity type:Individual
Prefix:
First Name:ELYSSA
Middle Name:
Last Name:MALINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MARTINE AVE APT 804
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-4023
Mailing Address - Country:US
Mailing Address - Phone:845-702-8254
Mailing Address - Fax:
Practice Address - Street 1:25 MARTINE AVE APT 804
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-4023
Practice Address - Country:US
Practice Address - Phone:845-702-8254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty