Healthcare Provider Details

I. General information

NPI: 1255263752
Provider Name (Legal Business Name): CHLOE MALLEY
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: ADAM MALLEY

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 PLEASANT ST
CONCORD NH
03301-4006
US

IV. Provider business mailing address

29 SCHOOL ST
CONCORD NH
03301-4033
US

V. Phone/Fax

Practice location:
  • Phone: 603-226-0817
  • Fax:
Mailing address:
  • Phone: 603-225-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: