Individual
CONOR J MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1625 S OSPREY AVE, SARASOTA, FL 34239-2929
(941) 917-7760
(941) 917-8805
Mailing address
PO BOX 947407, ATLANTA, GA 30394-7407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
R5130
KY
2084P0800X
Psychiatry Physician
Primary
ME167460
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2019
Last updated
05/16/2024
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