Individual
MS. ELIZABETH MOORE MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
4939 BRITTONFIELD PKWY. BLDG. B., SUITE 210, DR. DOUGLAS W. HALLIDAY MD, P.C., EAST SYRACUSE, NY 13057-9208
(315) 471-8404
(315) 701-4877
Mailing address
4939 BRITTONFIELD PKWY. BLDG.B., SUITE 210, DR. DOUGLAS W. HALLIDAY MD, P.C., EAST SYRACUSE, NY 13057-9208
(315) 471-8404
(315) 701-4877
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F304384-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006007950
ANCC CERTIFICATION
—
01
—
399466
MVP PROVIDER IDENTIFER NUMBER
NY
Enumeration date
12/27/2006
Last updated
03/07/2023
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