Individual
ATRAYEE BASU MALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1015 CHESTNUT ST, SUITE 1321, PHILADELPHIA, PA 19107-4316
(215) 923-5676
(215) 923-7390
Mailing address
615 CHESTNUT ST, 14TH FLOOR, PHILADELPHIA, PA 19106-4404
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD440064
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0233242
—
NJ
05
—
102474760
—
PA
Enumeration date
06/01/2010
Last updated
05/26/2011
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