Individual
DR. ANDREA D. MALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2748 HYLAN BLVD, STATEN ISLAND, NY 10306-4658
(718) 979-2200
(718) 979-3435
Mailing address
2748 HYLAN BLVD, STATEN ISLAND, NY 10306-4658
(718) 979-2200
(718) 979-3435
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV006193-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TUV006193-1
LICENSE
NY
Enumeration date
11/28/2006
Last updated
02/10/2010
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