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General NPI Number Information
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NPI Number | 1164943395
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Entity Type | Organization
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Legal Business Name | DR. PHILLIP MALVASI D.O. LLC
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1017 YOUNGSTOWN WARREN RD
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City | NILES
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State | OH
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Zip | 44446-4620
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Country | US
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Telephone | 330-544-5600
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Fax | 330-544-5550
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Provider Business Mailing Address
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Address Line | 1017 YOUNGSTOWN WARREN RD
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City | NILES
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State | OH
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Zip | 44446-4620
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Country | US
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Telephone | 330-544-5600
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Fax | 330-544-5550
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. PHILLIP MALVASI DO LLC
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Credential | DO
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Telephone | 330-544-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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