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Individual

ATHANASIOS MALLIOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
15 WEST 72ND STREET, SUITE LT, NEW YORK, NY 10023
(212) 787-0091
(212) 721-1636
Mailing address
15 WEST 72ND STREET, SUITE LT, NEW YORK, NY 10023
(212) 787-0091
(212) 721-1636

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
120555
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00305037
NY
Enumeration date
10/23/2006
Last updated
02/26/2010
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