Individual
ERIC JAMES MALLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
505 E 70TH ST FL 3, NEW YORK, NY 10021
(212) 746-3278
Mailing address
6201 GREENLEIGH AVE FL 2, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
277733
NY
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
D97854
MD
Other
Enumeration date
04/10/2012
Last updated
01/15/2025
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