Individual
MARGUERITE H MALLIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5075 W SENECATPKE, VAN DUYN HOME & HOSPITAL, SYRACUSE, NY 13215-2292
(315) 435-5511
(315) 435-5520
Mailing address
303 STRATHMORE DR, SYRACUSE, NY 13207-1551
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F303417-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F303417-1
NYS NURSE PRACT LICENSE
NY
Enumeration date
01/05/2007
Last updated
07/08/2007
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