Individual
MRS. MICHELLE ANNE MALLAMUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADULT NP
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(646) 422-4413
Mailing address
6 CIRCLE DR, MOUNT KISCO, NY 10549-3604
(251) 753-2980
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305634
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922390541
NPI
NY
Enumeration date
05/16/2011
Last updated
10/28/2012
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