Individual
MALLORY ANNE SMALLZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22-18 BROADWAY, FAIR LAWN, NJ 07410-3016
(201) 414-9840
Mailing address
13 DOROTHY AVE, ROCHELLE PARK, NJ 07662-3303
(201) 421-7757
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ01325700
NJ
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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