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General NPI Number Information
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NPI Number | 1801889787
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Entity Type | Individual
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Provider Name | PAUL MALLARI PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 1526 ATWOOD AVE STE 220
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City | JOHNSTON
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State | RI
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Zip | 02919-3289
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Country | US
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Telephone | 401-396-2227
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Fax | 401-421-1120
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Provider Business Mailing Address
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Address Line | 79 CLIFF DR
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City | ASSONET
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State | MA
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Zip | 02702-1377
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Country | US
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Telephone | 401-529-7787
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Fax | 508-674-8880
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA00270
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License Number State | RI
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