Individual
MELISSA A. MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3998 RED LION RD, PHILADELPHIA, PA 19114-1445
(215) 612-4088
(215) 612-4323
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-0001
(215) 807-8000
(215) 807-8235
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN517426L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00414536
MEDICARE RAILROAD
PA
Enumeration date
07/05/2006
Last updated
02/26/2015
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