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Individual

DR. ALI IMRAN MALLICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
355 BARD AVE, DEPARTMENT OF PSYCHIATRY, 1ST FLOOR, STATEN ISLAND, NY 10310
(718) 818-4121
Mailing address
7534 193RD ST, FRESH MEADOWS, NY 11366-1834
(917) 650-9930

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
320321
NY
2084P0804X
Child & Adolescent Psychiatry Physician
320321
NY

Other

Enumeration date
05/23/2019
Last updated
09/16/2025
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