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Individual

DR. BRUCE RICHARD MALEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
33 RONALD REAGAN BLVD, WARWICK, NY 10990-0833
(845) 986-6601
(845) 986-6613
Mailing address
33 RONALD REAGAN BLVD, PO BOX 833, WARWICK, NY 10990-0833
(845) 986-6601
(845) 986-6613

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20386
NY
207W00000X
Ophthalmology Physician
25MA03318400
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00305202
NY
Enumeration date
10/25/2006
Last updated
10/05/2010
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