Provider Demographics
NPI:1871103531
Name:MALAYIL, STEFFY (PA-C)
Entity type:Individual
Prefix:
First Name:STEFFY
Middle Name:
Last Name:MALAYIL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 NEWMAN SPRINGS RD STE 220
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5792
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:
Practice Address - Street 1:960 E HARVARD AVE FL 1
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-7008
Practice Address - Country:US
Practice Address - Phone:303-778-5774
Practice Address - Fax:303-778-2436
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00579300363A00000X
1173623363A00000X
COPA.0006490363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant