Individual
MS. MAHAM MALLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 CONEY ISLAND AVE, BROOKLYN, NY 11230-5849
(718) 998-1415
Mailing address
98 RIDGE LN, LEVITTOWN, NY 11756-1151
(516) 312-2329
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
01/30/2021
Last updated
01/30/2021
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