MALLICK QAISER ALAM (NPI# 1467529271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467529271 |
| Entity Type | Individual |
| Full Name | MALLICK QAISER ALAM |
| Other Name | QAISER MALLICK |
| Credential | MD |
| Practice Address |
77 Grand Ave New Haven CT 06513-3906 |
| Practice Telephone | 2035628697 |
| Practice Fax Number | 2035621822 |
| Mailing Telephone | 2035628697 |
| Mailing Fax Number | 2035621822 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 034112 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
77 GRAND AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06513-3906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285837401 | New Haven Walk In Medical Center | Pediatrics | 77 Grand Ave, New Haven, CT 06513-3906 | 2007-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366906141 | Edward Rivera | Case Manager/Care Coordinator | 458 Grand Ave., Suite 103, New Haven, CT 06513 | 2019-01-25 |
| 1134698442 | Village of Angels Home Health Care LLC | Respite Care | 470 James Street, Suite 007, New Haven, CT 06513 | 2018-11-15 |
| 1609358068 | Sarah Khalil | Pharmacist | 745 Foxon Road, East Haven, CT 06513 | 2018-09-02 |
| 1912358375 | Domanice Poindexter | Nurse Practitioner | Caremore Health, 444 Foxon Rd, East Haven, CT 06513 | 2016-06-28 |
| 1568839876 | My Fair Haven Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 72 Grand Ave, New Haven, CT 06513 | 2015-08-24 |
| 1871979567 | Sankofa Counseling LLC | Community/Behavioral Health | 64 Thompson St Ste A101, East Haven, CT 06513 | 2015-08-04 |
| 1578967287 | Curtis Stewart | Pharmacy Technician | 661 Thompson Street, East Haven, CT 06513 | 2014-10-09 |
| 1548686322 | Davis Group LLC | Social Worker | 30 Grand Ave, New Haven, CT 06513 | 2014-03-17 |
| 1124459615 | James Lucas IIi | Dietitian, Registered | 167 Old Foxon Road, Unit 30b, New Haven, CT 06513 | 2013-12-09 |
| 1609206135 | Spretha Kadavath | Dentist | 50 Grand Ave, New Haven, CT 06513 | 2013-11-19 |
| Find all providers in zip 06513 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548520661 | Cynthia Zywocinski | General Practice | 92 Everit St, New Haven, CT 06511-1321 | 2012-05-23 |
| 1720215817 | Nirmala Panwar | General Practice | 566 Orchard St, Yhcp Dba 828 - Urgent Care, New Haven, CT 06511-3214 | 2009-06-16 |
| 1932126448 | Alfred J Ranieri Jr. | General Practice | 1455 Chapel St, New Haven, CT 06511-4403 | 2006-07-17 |
| 1679986277 | Stephanie Douglas | General Practice | 20 York St, New Haven, CT 06510-3220 | 2014-06-11 |
| 1730167404 | Prashanth Vallabhajosyula | General Practice | 800 Howard Ave, New Haven, CT 06519-1369 | 2006-01-04 |
| 1710960935 | Walter N Kernan | General Practice | 789 Howard Ave, New Haven, CT 06519-1304 | 2005-11-22 |
| 1760465991 | Cary E Gross | General Practice | 789 Howard Ave, Ynhh, New Haven, CT 06519-1304 | 2005-11-22 |
| 1063495158 | Lynn E Fiellin | General Practice | 800 Howard Ave, Yale Physicians Building, New Haven, CT 06519-1369 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669029773 | Medexpress Primary Care Texas, P.a. | General Practice | 185 Asylum Street, City Place 1, Hartford, CT 06103-3408 | 2019-08-22 |
| 1225510571 | David Warren Boxwell | General Practice | 67 Church St., Suite 300, Norwich, CT 06360-0636 | 2018-09-04 |
| 1407234685 | Adrian Kenneth Wyllie | General Practice | 4 Research Pkwy, Wallingford, CT 06492-1929 | 2015-05-08 |
| 1740612829 | Stanley Brovender | General Practice | 773b Pontiac Lane, Stratford, CT 06614 | 2013-07-31 |
| 1528300191 | Theodore Herbert Johnson | General Practice | 141 S Mountain Dr, New Britain, CT 06052-1511 | 2013-03-21 |
| 1811237142 | Jose Buhain | General Practice | 19 Judson Ave Apt 5d, Woodbury, CT 06798-2844 | 2013-02-23 |
| 1093071631 | Roger Joseph Branson | General Practice | 12 Woodcreek Rd, Bethlehem, CT 06751-1705 | 2012-04-09 |
| 1427323401 | Kevin David Wolter | General Practice | 43 Oxford Ct, Mystic, CT 06355-1705 | 2012-03-09 |
| 1144590191 | Richard John Annulli | General Practice | 1037 Valley Rd, New Canaan, CT 06840-2818 | 2012-01-09 |
| 1578831525 | Alan Jule Ranhosky | General Practice | 2874 Long Ridge Rd, Stamford, CT 06903-1119 | 2011-12-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.