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NPI Code Detail

MEDICARE: DR. ERROL CHARLES MALLETT MD

MEDICARE: DR. ERROL CHARLES MALLETT 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
1174400000XSpecialist146738NY
2208800000XUrology Physician146738-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992785315
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERROL CHARLES MALLETT MD
Provider Business Mailing Address
First Line : PO BOX 6054
Second Line :
City : SPRING HILL
State : FL
Zip : 34611-6054
Country : US
Telephone Number : 917-688-2534
Fax Number : 800-420-3318
Provider Business Practice Location Address
First Line : 2101 AVENUE X
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-2910
Country : US
Telephone Number : 718-517-2900
Fax Number : 718-891-6800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 10/12/2023

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