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General NPI Number Information
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NPI Number | 1013950641
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Entity Type | Individual
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Provider Name | DOUGLAS MAILLY MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | HUDSON VALLEY HOSPITAL CENTER (EMERGENCY DEPARTMENT) 1980 CROMPOND ROAD
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567
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Country | US
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Telephone | 914-737-9000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 718
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City | LIVINGSTON
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State | NJ
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Zip | 07039-0718
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Country | US
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Telephone | 973-740-0607
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 17886
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 189936-1
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License Number State | NY
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