Individual
MALLORY K PINGETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 983-7000
Mailing address
64 ARDALE ST, ROSLINDALE, MA 02131-1403
(978) 809-0852
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3990
MA
363AM0700X
Medical Physician Assistant
PA3990
MA
363AS0400X
Surgical Physician Assistant
PA3990
MA
Other
Enumeration date
06/25/2010
Last updated
11/25/2013
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