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Organization
NEIL J. MALLIS, M.D. INC
Active
Organization
NEIL J. MALLIS, M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL J. MALLIS (MEDICAL DIRECTOR)
(215) 335-1220
Entity
Organization
Contact information
Practice address
7335 FRANKFORD AVE, PHILADELPHIA, PA 19136-3929
(215) 335-1220
(215) 335-2517
Mailing address
7335 FRANKFORD AVE, PHILADELPHIA, PA 19136-3929
(215) 335-1220
(215) 335-2517
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD031074E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2079177
HIGHMARK BLUE SHIELD
PA
01
—
3553245000
PERSONAL CHOICE
PA
01
—
3553245001
KEYSTONE IBC
PA
Enumeration date
01/13/2009
Last updated
03/05/2009
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