Provider Demographics
NPI:1396157319
Name:DUNTON, MALAIKA OMINA
Entity type:Individual
Prefix:MISS
First Name:MALAIKA
Middle Name:OMINA
Last Name:DUNTON
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 1:950 UNDERHILL AVE APT 6F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2733
Mailing Address - Country:US
Mailing Address - Phone:347-679-0306
Mailing Address - Fax:
Practice Address - Street 1:950 UNDERHILL AVE
Practice Address - Street 2:6F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2750
Practice Address - Country:US
Practice Address - Phone:347-679-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-25
Last Update Date:2014-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program