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Individual

MR. SCOTT ROBERT MALLON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1688 VICTORY BLVD, STATEN ISLAND, NY 10314-3547
(718) 815-4111
Mailing address
1688 VICTORY BLVD, STATEN ISLAND, NY 10314-3547
(718) 815-4111

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000874-1
NY

Other

Enumeration date
07/25/2011
Last updated
07/25/2011
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