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NPI Code Detail

MEDICARE: DR. MAURA KAYE MALLOY PSYD

MEDICARE: DR. MAURA KAYE MALLOY PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologistPY0004985FL

General Provider Information

NPI Number : 1437105475
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAURA KAYE MALLOY PSYD
Provider Business Mailing Address
First Line : 1081 NW 5TH AVE
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-3524
Country : US
Telephone Number : 561-533-3903
Fax Number : 561-244-5149
Provider Business Practice Location Address
First Line : 2500 QUANTUM LAKES DR
Second Line : STE 203
City : BOYNTON BEACH
State : FL
Zip : 33426-8323
Country : US
Telephone Number : 561-533-3903
Fax Number : 561-244-5149
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 08/01/2021

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