MALLORY DES CHAMPS (NPI# 1740848985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740848985 |
| Entity Type | Individual |
| Full Name | MALLORY DES CHAMPS |
| Practice Address |
7901 4th Ave Ste A20 Brooklyn NY 11209-3957 |
| Mailing Address |
1150 Douglas Pike Smithfield RI 02917-1291 |
| Practice Telephone | 7184915800 |
| Practice Fax Number | 7187482151 |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-12-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7901 4TH AVE STE A20 |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11209-3957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083233324 | Saitta Dermatology PC | Dermatology | 7901 4th Ave Ste A20, Brooklyn, NY 11209-3957 | 2020-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649897737 | Antar, LLC | Optometrist | 9714 Fourth Ave, Store Front, Brooklyn, NY 11209 | 2020-07-06 |
| 1184250540 | Daily Strength Physical Therapy Pllc | Physical Therapist | 343 Marshall Drive N #2a, Brooklyn, NY 11209 | 2020-03-18 |
| 1306492731 | Penny Planzos | Dentist | 7815 4th Avenue, Brooklyn, NY 11209 | 2019-08-12 |
| 1932660917 | Kristen Elizabeth Dalelio | Social Worker | 9401 4th Ave Fl 1, Brooklyn, NY 11209 | 2019-03-30 |
| 1346706413 | Yelena Lobova | Specialist | 7100 Ridge Blvd Apt 3c, Brooklyn, NY 11209 | 2019-02-13 |
| 1841781648 | Ian Rugg Psychology Pllc | Psychologist | 545 73rd Street, Ground Floor, Brooklyn, NY 11209 | 2018-05-29 |
| 1194227520 | Constantinos Kokkinos | Social Worker | 37 72nd St Apt 1, Brooklyn, NY 11209 | 2018-03-01 |
| 1760905186 | Ankita Luthra | Student in an Organized Health Care Education/Training Program | 470 84th Street Brooklyn, New York, NY 11209 | 2017-07-18 |
| 1700308186 | Griselda Marleny Rodriguez Jorge | Social Worker | 1 74th Street, Apt 4m, Brooklyn, NY 11209 | 2017-07-07 |
| 1932629854 | Jonathan Dennehy | Social Worker | 307 West 38th Street, Suite 817, New York, NY 11209 | 2017-06-21 |
| Find all providers in zip 11209 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710517305 | Angenis Lin | Physician Assistant | 1526 83rd St, Brooklyn, NY 11228-3130 | 2020-01-22 |
| 1588140230 | Sharon Cheptum Griesinger | Physician Assistant | 276 Hawthorne St Apt 1, Brooklyn, NY 11225-5908 | 2018-07-16 |
| 1336651629 | Francine Panely | Physician Assistant | 460 Neptune Ave Apt 18r, Brooklyn, NY 11224-4325 | 2017-10-26 |
| 1265951479 | Leah Mcmullen | Physician Assistant | 803 Nostrand Ave Apt 1l, Brooklyn, NY 11225-1539 | 2017-09-19 |
| 1033655378 | Zacharia El-samin | Physician Assistant | 21 Pine Tree Ter, Brooklyn, CT 06234-3324 | 2017-01-10 |
| 1982156816 | Chad Smartt | Physician Assistant | 988 E 39th St, Brooklyn, NY 11210-3508 | 2016-10-26 |
| 1154870913 | Christina Masaitis | Physician Assistant | 2171 E 18th St, Apt 1c, Brooklyn, NY 11229-4468 | 2016-09-22 |
| 1447615737 | Eliezer Gurkov | Physician Assistant | 888 Montgomery St, Apt F12, Brooklyn, NY 11213-5888 | 2015-12-31 |
| 1588039846 | Inna Kremen | Physician Assistant | 2829 Ocean Pkwy Ste 3, Brooklyn, NY 11235-7859 | 2015-12-11 |
| 1801261953 | Perpetue Dorilas | Physician Assistant | 937 E 96th St, Brooklyn, NY 11236-2303 | 2015-12-01 |
| Find all providers in BROOKLYN | ||||
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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.