Individual
CHRISTOPHER THOMAS MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
230 N BROAD ST, PHILADELPHIA, PA 19102-1121
(215) 762-7922
(215) 762-8656
Mailing address
24 S 18TH ST, ALLENTOWN, PA 18104-5622
(610) 628-8372
(610) 628-8648
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR15663400
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
RN600018
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101375
AANA
PA
Enumeration date
12/12/2013
Last updated
06/27/2019
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