Organization
MARY MALLAVARAPU MD
Active
Parent organization
MARY MALLAVARAPU MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY MALLAVARAPU MD
Authorized official
MS. ANITA SOARES MBA (OFFICE MANAGER)
(845) 634-0068
Entity
Organization
Contact information
Practice address
100 PHILLIPS HILL RD, NEW CITY, NY 10956-4134
(845) 634-0068
Mailing address
971 ROUTE 45, SUITE 112, POMONA, NY 10970-3500
(845) 354-8054
(845) 354-1807
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
121643
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00515435
—
NY
Enumeration date
05/11/2009
Last updated
05/11/2009
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