Individual
KRISTIE MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 HADDON AVE, CAMDEN, NJ 08103-3101
(856) 247-2160
(856) 247-2165
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00943500
NJ
363A00000X
Physician Assistant
MA056898
PA
363AM0700X
Medical Physician Assistant
MA056898
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103143340
—
PA
Enumeration date
06/13/2014
Last updated
09/24/2025
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