Individual
SOBHA MALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CSR
Contact information
Practice address
121 CENTER GROVE RD, RANDOLPH, NJ 07869-4453
(315) 834-2382
Mailing address
121 CENTER GROVE RD, RANDOLPH, NJ 07869-4453
(510) 792-2652
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
931194
NJ
Other
Enumeration date
01/23/2015
Last updated
11/16/2023
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