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NPI Code Detail

MEDICARE: MARGARET ANN MALLOY PA-C

MEDICARE:   MARGARET ANN MALLOY  PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1780283986
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET ANN MALLOY PA-C
Provider Business Mailing Address
First Line : 1932 CHRISTIAN ST APT B
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19146-2665
Country : US
Telephone Number : 614-560-7926
Fax Number :
Provider Business Practice Location Address
First Line : 3223 N BROAD ST FL 1
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5007
Country : US
Telephone Number : 215-707-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2020
Last Update Date : 10/20/2020

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Directions to “ MARGARET ANN MALLOY PA-C” Practice Location

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