Individual
MS. MELINDA LISA MALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
111 EAST 210TH STREET, MONTEFIORE HOSPITAL - TRANSPLANT OFFICE RC, BRONX, NY 10467-2554
(718) 920-4459
(718) 547-4773
Mailing address
3450 WAYNE AVENUE, APT 26E, BRONX, NY 10467-2554
(718) 405-2148
(718) 547-4773
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001218
NY
363AM0700X
Medical Physician Assistant
001218
NY
363AS0400X
Surgical Physician Assistant
Primary
001218
NY
Other
Enumeration date
10/05/2006
Last updated
09/11/2025
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