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NPI Code Detail

MEDICARE: DR. CHRISTINA MALLERY DO

MEDICARE: DR. CHRISTINA MALLERY DO
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
1207XP3100XPediatric Orthopaedic Surgery Physician335838NY
2207XX0005XSports Medicine (Orthopaedic Surgery) Physician335838NY
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1780265900
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINA MALLERY DO
Provider Business Mailing Address
First Line : 601 ELMWOOD AVE BOX 665
Second Line :
City : ROCHESTER
State : NY
Zip : 14642-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10 MIRACLE MILE DR
Second Line :
City : ROCHESTER
State : NY
Zip : 14623-5851
Country : US
Telephone Number : 585-275-5321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2021
Last Update Date : 01/13/2026

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