Individual
MATTHEW JAMES MALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1214 BENNINGTON ST, EAST BOSTON, MA 02128-1203
(617) 569-6607
(617) 569-8302
Mailing address
1214 BENNINGTON ST, EAST BOSTON, MA 02128-1203
(617) 569-6607
(617) 569-8302
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
681
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076391
AETNA
—
05
—
1601776
—
MA
01
—
351011
HARVARDPILGRIM HEALTHCARE
MA
01
—
714763
TUFTS HEALTH PLAN
—
01
—
7909287001
CIGNA
—
01
—
Y35466
BC/BS OF MA
MA
Enumeration date
10/05/2007
Last updated
07/09/2008
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