Individual
DR. CARMELITA PINGOL MALALIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
765 KENNEDY BLVD., BAYONNE, NJ 07002-2804
(201) 437-9471
(201) 437-1590
Mailing address
54 BARBOUR PLACE, PISCATAWAY, NJ 08854-3591
(732) 563-4424
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MA03062500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0932604
—
NJ
Enumeration date
09/06/2006
Last updated
07/08/2007
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