Individual
DR. GREGORY CHARLES MALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6 TECHNOLOGY DR 100, EAST SETAUKET, NY 11733-4079
(631) 689-6698
(631) 751-5548
Mailing address
6 TECHNOLOGY DR 100, EAST SETAUKET, NY 11733-4079
(631) 689-6698
(631) 751-5548
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
280603
NY
Other
Enumeration date
12/01/2007
Last updated
11/18/2015
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