Individual
MS. MALA VAZIRANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 470-7000
Mailing address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 470-7000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006159
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02353955
—
NY
Enumeration date
12/28/2005
Last updated
03/18/2013
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