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Organization
BHOOSA MALLIAH, MD. PA
Active
Organization
BHOOSA MALLIAH, MD. PA
Active
Other names
BHOOSAMALLIAH,MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHOOSA MALLIAH M.D. (PHYSICIAN)
(732) 840-8688
Entity
Organization
Contact information
Practice address
222 JACK MARTIN BLVD, SUITE. E,, BRICKTOWN, NJ 08724-7772
(732) 840-8688
(732) 840-8480
Mailing address
222 JACK MARTIN BLVD, SUITE. E,, BRICKTOWN, NJ 08724-7772
(732) 840-8688
(732) 840-8480
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
02/23/2006
Last updated
09/20/2007
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