| Shahla Mallick Medical Pc | |
|
517 54th St Brooklyn NY 11220-3114 | |
| (718) 833-7860 | |
| (718) 833-7861 |
| Full Name | Shahla Mallick Medical Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 517 54th St, Brooklyn, New York |
| Authorized Official Name and Position | Shahla Mallick (DOCTOR) |
| Authorized Official Contact | 7188337860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shahla Mallick Medical Pc 208 Parkway Dr Roslyn Heights NY 11577-2737 Ph: (718) 833-7860 | Shahla Mallick Medical Pc 517 54th St Brooklyn NY 11220-3114 Ph: (718) 833-7860 |
| NPI Number | 1245536440 |
|---|---|
| Provider Enumeration Date | 02/04/2011 |
| Last Update Date | 06/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245536440 | NPI | - | NPPES |
| 02106307 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 217612 (New York) | Primary |
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