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General NPI Number Information
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NPI Number | 1801914395
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Entity Type | Individual
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Provider Name | PRIYA MALIK RPA-C
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 205-07 HILLSIDE AVE STE # 4
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City | HOLLIS
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State | NY
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Zip | 11423
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Country | US
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Telephone | 718-740-4066
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Fax | 718-740-3789
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Provider Business Mailing Address
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Address Line | 97-10 62ND DRIVE APT #15 K
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City | REGO PARK
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State | NY
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Zip | 11374
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Country | US
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Telephone | 718-830-9262
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 009899
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License Number State | NY
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