Individual
MISS CARRIE R. MALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
370 SUMMIT AVE, HACKENSACK, NJ 07601-1413
(201) 525-1777
(201) 525-0149
Mailing address
370 SUMMIT AVE, HACKENSACK, NJ 07601-1413
(201) 525-1777
(201) 525-0149
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00174800
NJ
Other
Enumeration date
06/05/2008
Last updated
10/15/2009
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