Organization
DR. MARIO S. MALONZO, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO SUPAN MALONZO M.D. (PRESIDENT)
(718) 597-5450
Entity
Organization
Contact information
Practice address
1386 WHITE PLAINS RD, BRONX, NY 10462-4102
(718) 597-5450
(914) 722-1730
Mailing address
56 WALWORTH AVE, SCARSDALE, NY 10583-1423
(914) 725-0751
(914) 722-1730
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
152890
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00898540
—
NY
Enumeration date
11/02/2006
Last updated
06/22/2008
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