Individual
CHRISTOPHER T MALLAVARAPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
515 MAIN ST, OLEAN, NY 14760-1513
(716) 373-2600
Mailing address
86 NAVESINK AVE, RUMSON, NJ 07760-2043
(337) 296-8523
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
183914
NY
207UN0901X
Nuclear Cardiology Physician
183914
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01365920
—
NY
01
—
130730000068
FIDELIS
NY
01
—
3997380
EMBLEM HEALTH
NY
Enumeration date
05/23/2005
Last updated
07/24/2024
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