Individual
MALLORY NAKAMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4295 HEMPSTEAD TPKE, BETHPAGE, NY 11714-5713
(516) 579-6000
Mailing address
1400 PELHAM PKWY S STE 1213, BRONX, NY 10461-1197
(718) 918-5599
(718) 918-5593
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
024639
NY
Other
Enumeration date
02/18/2020
Last updated
12/03/2022
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