Provider Demographics
NPI:1992747885
Name:MALAVE, ESTHER (MD)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:MALAVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:20 S BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:RUNNEMEDE
Practice Address - State:NJ
Practice Address - Zip Code:08078-1901
Practice Address - Country:US
Practice Address - Phone:856-962-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419408207Q00000X
NJ25MA06842200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001901404Medicaid
PA11372OtherBRAVO HEALTH
PA2083798000OtherINDEPENDENCE BLUE CROSS
PA30042690OtherKEYSTONE MERCY HEALTH
PA597586OtherMEDICARE GROUP
PA1394563OtherHIGHMARK BLUE SHIELD
PA2719049OtherCIGNA
PAG90958Medicare UPIN
PA001901404Medicaid
PA597586Medicare PIN