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1124432034 NPI number — CHRISTINA MALLOS

NPI Number: 1124432034
Health Care Provider/Practitioner: CHRISTINA MALLOS

Information about “1124432034” NPI (CHRISTINA MALLOS) exists in 1124432034 in HTML format HTML  |  1124432034 in plain Text format TXT  |  1124432034 in PDF (Portable Document Format) PDF  |  1124432034 in an XML format XML  formats.

NPI Number : 1124432034 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124432034",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MALLOS",
    "FirstName": "CHRISTINA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MALLOS",
    "OtherFirstName": "TAYLOR",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "5481 E GILL PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DENVER",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80246-1410",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "303-847-7352",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2050 S ONEIDA ST",
    "SecondLinePracticeLocationAddress": "#220",
    "PracticeLocationAddressCityName": "DENVER",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80224-2437",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "303-847-7352",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/18/2014",
    "LastUpdateDate": "06/18/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225700000X",
        "TaxonomyName": "Massage Therapist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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