Individual
DR. ADNAN M. MALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1255 BROAD ST STE 104, BLOOMFIELD, NJ 07003-3061
(973) 707-5632
(973) 707-7349
Mailing address
1 CORPORATE DR, WAYNE, NJ 07470-3112
(973) 987-3380
(866) 806-3675
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA10886200
NJ
207WX0107X
Retina Specialist (Ophthalmology) Physician
25MA10886200
NJ
207WX0107X
Retina Specialist (Ophthalmology) Physician
277002
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230917
—
OH
Enumeration date
06/13/2013
Last updated
03/22/2022
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