Provider Demographics
NPI:1982399952
Name:CASA-MALONE, TIMOTHY RYAN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:RYAN
Last Name:CASA-MALONE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HEALTH SCIENCES CENTER T19-030 STONY BROOK MEDICINE
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-1791
Mailing Address - Fax:631-444-7689
Practice Address - Street 1:39 MONTGOMERY AVE
Practice Address - Street 2:DEPT OF ANESTHESIOLOGY
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8004
Practice Address - Country:US
Practice Address - Phone:631-894-5939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program