Individual
AZRIA MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 STANLEY ST, NEW BRITAIN, CT 06050-2439
(860) 832-3200
Mailing address
308 MUNGER LN, BETHLEHEM, CT 06751-1100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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