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NPI Code Detail

MEDICARE: DR. DEBRA SUE MALLEY MD

MEDICARE: DR. DEBRA SUE MALLEY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianMA63875NJ

General Provider Information

NPI Number : 1447299748
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEBRA SUE MALLEY MD
Provider Business Mailing Address
First Line : 88 LAKEVIEW DR S
Second Line : SUITE 2A
City : GIBBSBORO
State : NJ
Zip : 08026-1229
Country : US
Telephone Number : 856-309-0345
Fax Number : 856-309-1213
Provider Business Practice Location Address
First Line : 88 LAKEVIEW DR S
Second Line : SUITE 2A
City : GIBBSBORO
State : NJ
Zip : 08026-1229
Country : US
Telephone Number : 856-309-0345
Fax Number : 856-309-1213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 07/08/2007

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